PMID- 23042966
OWN - NLM
STAT- MEDLINE
DCOM- 20130619
LR  - 20121211
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Linking)
VI  - 56
IP  - 1
DP  - 2013 Jan
TI  - Epidemiology and morbidity of Epstein-Barr virus infection in pediatric renal 
      transplant recipients: a multicenter, prospective study.
PG  - 84-92
LID - 10.1093/cid/cis823 [doi]
AB  - BACKGROUND: The epidemiology and morbidity of Epstein-Barr virus (EBV) infection 
      in pediatric renal transplant recipients have been characterized insufficiently. 
      METHODS: In a prospective, multicenter study among 106 pediatric kidney allograft 
      recipients aged 11.4 +/- 5.9 years, we investigated the epidemiology of EBV 
      infection and the relationship between EBV load, EBV serology, and EBV-related 
      morbidity (posttransplant lymphoproliferative disease [PTLD] or symptomatic EBV 
      infection, defined as flu-like symptoms or infectious mononucleosis). RESULTS: 
      EBV primary infection occurred in 27 of 43 (63%) seronegative patients and 
      reactivation/reinfection in 28 of 63 (44%) seropositive patients. There was no 
      association between the degree or duration of EBV load and EBV-related morbidity: 
      The vast majority (17 of 18 [94%]) of patients with a high, persistent EBV load 
      remained PTLD-free throughout a follow-up of 5.0 +/- 1.3 years, while 2 of 3 (66%) 
      patients with EBV-related PTLD exhibited only a low EBV load beforehand. Eight of 
      18 (44%) patients with a high, persistent EBV load remained asymptomatic during a 
      follow-up of 5.3 +/- 2.9 years. Multivariate analysis identified the EBV high-risk 
      (D(+)/R(-)) serostatus (odds ratio [OR], 7.07; P < .05), the presence of human 
      leukocyte antigen (HLA)-DR7 (OR, 5.65; P < .05), and the intensity of the 
      immunosuppressive therapy (OR, 1.53; P < .01) as independent risk factors for the 
      development of a symptomatic EBV infection. CONCLUSIONS: Presence of EBV 
      high-risk seroconstellation, HLA-DR7, and intensity of immunosuppressive therapy 
      are significant risk factors for a symptomatic EBV infection, whereas there is no 
      close association between the degree or duration of EBV load and EBV-related 
      morbidity. Clinical Trials Registration. NCT00963248.
FAU - Hocker, Britta
AU  - Hocker B
AD  - University Children's Hospital, Im Neuenheimer Feld 430, D-69120 Heidelberg, 
      Germany.
FAU - Fickenscher, Helmut
AU  - Fickenscher H
FAU - Delecluse, Henri-Jacques
AU  - Delecluse HJ
FAU - Bohm, Stephan
AU  - Bohm S
FAU - Kusters, Uta
AU  - Kusters U
FAU - Schnitzler, Paul
AU  - Schnitzler P
FAU - Pohl, Martin
AU  - Pohl M
FAU - John, Ulrike
AU  - John U
FAU - Kemper, Markus J
AU  - Kemper MJ
FAU - Fehrenbach, Henry
AU  - Fehrenbach H
FAU - Wigger, Marianne
AU  - Wigger M
FAU - Holder, Martin
AU  - Holder M
FAU - Schroder, Monika
AU  - Schroder M
FAU - Billing, Heiko
AU  - Billing H
FAU - Fichtner, Alexander
AU  - Fichtner A
FAU - Feneberg, Reinhard
AU  - Feneberg R
FAU - Sander, Anja
AU  - Sander A
FAU - Kopf-Shakib, Sabine
AU  - Kopf-Shakib S
FAU - Susal, Caner
AU  - Susal C
FAU - Tonshoff, Burkhard
AU  - Tonshoff B
LA  - eng
SI  - ClinicalTrials.gov/NCT00963248
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20121005
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (Antiviral Agents)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adolescent
MH  - Analysis of Variance
MH  - Antiviral Agents/therapeutic use
MH  - Child
MH  - Epstein-Barr Virus Infections/*epidemiology/immunology/therapy/virology
MH  - Female
MH  - Graft Rejection/drug therapy/prevention & control
MH  - Herpesvirus 4, Human/immunology/*isolation & purification
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Kidney Transplantation/*statistics & numerical data
MH  - Lymphoproliferative Disorders/epidemiology/etiology/virology
MH  - Male
MH  - Morbidity
MH  - Prospective Studies
MH  - Statistics, Nonparametric
MH  - Transplants/statistics & numerical data
MH  - Viral Load
EDAT- 2012/10/09 06:00
MHDA- 2013/06/20 06:00
CRDT- 2012/10/09 06:00
PHST- 2012/10/09 06:00 [entrez]
PHST- 2012/10/09 06:00 [pubmed]
PHST- 2013/06/20 06:00 [medline]
AID - cis823 [pii]
AID - 10.1093/cid/cis823 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2013 Jan;56(1):84-92. doi: 10.1093/cid/cis823. Epub 2012 Oct 5.