TY - JOUR
T1 - Kinetics of cytomegalovirus and Epstein-Barr virus DNA in whole blood and plasma of kidney transplant recipients
T2 - Implications on management strategies
AU - AMCLI-GLaIT
AU - Lazzarotto, Tiziana
AU - Chiereghin, Angela
AU - Piralla, Antonio
AU - Gibertoni, Dino
AU - Piccirilli, Giulia
AU - Turello, Gabriele
AU - Campanini, Giulia
AU - Gabrielli, Liliana
AU - Costa, Cristina
AU - Comai, Giorgia
AU - La Manna, Gaetano
AU - Biancone, Luigi
AU - Rampino, Teresa
AU - Gregorini, Marilena
AU - Sidoti, Francesca
AU - Bianco, Gabriele
AU - Mauro, Maria Vittoria
AU - Greco, Francesca
AU - Cavallo, Rossana
AU - Baldanti, Fausto
PY - 2020
Y1 - 2020
N2 - This retrospective multicenter cohort study investigated the kinetics (ascending and descending phases) of cytomegalovirus (CMV) and Epstein-Barr virus (EBV)-DNA in whole blood (WB) and plasma samples collected from adult kidney transplant (KT) recipients. CMV-DNA kinetics according to antiviral therapy were investigated. Three hundred twenty-eight paired samples from 42 episodes of CMV infection and 157 paired samples from 26 episodes of EBV infection were analyzed by a single commercial molecular method approved by regulatory agencies for both matrices. CMV-DNAemia followed different kinetics in WB and plasma. In the descending phase of infection, a slower decay of viral load and a higher percentage of CMV-DNA positive samples were observed in plasma versus WB. In the 72.4% of patients receiving antiviral therapy, monitoring with plasma CMV-DNAemia versus WB CMV-DNAemia could delay treatment interruption by 7-14 days. Discontinuation of therapy based on WB monitoring did not result in relapsed infection in any patients. Highly different EBV-DNA kinetics in WB and plasma were observed due to lower positivity in plasma; EBV positive samples with a quantitative result in both blood compartments were observed in only 11.5% of cases. Our results emphasize the potential role of WB as specimen type for post-KT surveillance of both infections for disease prevention and management.
AB - This retrospective multicenter cohort study investigated the kinetics (ascending and descending phases) of cytomegalovirus (CMV) and Epstein-Barr virus (EBV)-DNA in whole blood (WB) and plasma samples collected from adult kidney transplant (KT) recipients. CMV-DNA kinetics according to antiviral therapy were investigated. Three hundred twenty-eight paired samples from 42 episodes of CMV infection and 157 paired samples from 26 episodes of EBV infection were analyzed by a single commercial molecular method approved by regulatory agencies for both matrices. CMV-DNAemia followed different kinetics in WB and plasma. In the descending phase of infection, a slower decay of viral load and a higher percentage of CMV-DNA positive samples were observed in plasma versus WB. In the 72.4% of patients receiving antiviral therapy, monitoring with plasma CMV-DNAemia versus WB CMV-DNAemia could delay treatment interruption by 7-14 days. Discontinuation of therapy based on WB monitoring did not result in relapsed infection in any patients. Highly different EBV-DNA kinetics in WB and plasma were observed due to lower positivity in plasma; EBV positive samples with a quantitative result in both blood compartments were observed in only 11.5% of cases. Our results emphasize the potential role of WB as specimen type for post-KT surveillance of both infections for disease prevention and management.
UR - http://www.scopus.com/inward/record.url?scp=85089932973&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85089932973&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0238062
DO - 10.1371/journal.pone.0238062
M3 - Article
C2 - 32841308
AN - SCOPUS:85089932973
VL - 15
SP - e0238062
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 8
ER -