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Interrelationships among Quantity of Human Cytomegalovirus (HCMV) DNA in Blood, Donor‐Recipient Serostatus, and Administration of Methylprednisolone as Risk Factors for HCMV Disease following Liver Transplantation

1997; Oxford University Press; Volume: 176; Issue: 6 Linguagem: Inglês

10.1086/514145

1537-6613

Alethea Cope, Caroline Sabin, Andrew K. Burroughs, Keith Rolles, Paul Griffiths, Vincent C. Emery,

Viral-associated cancers and disorders

Longitudinal analysis of 162 liver transplant recipients identified 51 patients who were viremic. Virus load was determined in 47 of these patients using quantitative-competitive polymerase chain reaction. Peak virus load was significantly higher in 20 symptomatic patients than 27 asymptomatic patients (P < .0001). Elevated virus load, donor seropositivity, and total methylprednisolone dosage were risk factors for human cytomegalovirus (HCMV) disease (odds ratio [OR], 2.22/0.25 log10 increase in virus load, P < .001; OR, 4.11, P < .05; OR, 1.30/1-g increment in methylprednisolone, P < .01). Methylprednisolone and virus load were independent risk factors in a multivariate analysis (OR, 2.70/1-g increase, P < .003; OR, 1.61/0.25 log10 increase, P < .03, respectively). Virus loads of 104.75–105.25 genomes/mL of blood were associated with an increased disease probability; the latter was shifted to lower virus loads with increasing quantities of methylprednisolone. These data illustrate the central role of virus load in HCMV pathogenesis.