Clinical Utility of Viral Load in the Management of Cytomegalovirus Infection in Solid Organ Transplant Patients in Kuwait
Abstract Background Infection with human cytomegalovirus (CMV) in solid organ transplant patients remains an unresolved challenge, despite improvements in immunosuppressive therapy, post-transplantation care, viral prevention, and therapy. Methods We conducted quantitative real-time polymerase chain...
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| Veröffentlicht in: | Transplantation proceedings 2015-07, Vol.47 (6), p.1802-1807 |
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| creator | Madi, N Al-Qaser, M Edan, R Al-Nakib, W |
| description | Abstract Background Infection with human cytomegalovirus (CMV) in solid organ transplant patients remains an unresolved challenge, despite improvements in immunosuppressive therapy, post-transplantation care, viral prevention, and therapy. Methods We conducted quantitative real-time polymerase chain reaction (PCR) assays of CMV on plasma samples of 1,168 patients in Kuwait who received solid organ transplants from 2012 to 2014 to detect and monitor CMV DNA viral load. Results Of the 1,168 patients, 180 (15.4%) were positive for CMV DNA. Among the CMV DNA–positive patients, 119 (66.1%) remained without symptoms and 61 (33.9%) developed CMV-related symptoms. During the follow-up period, peak viral loads were significantly ( P |
| doi_str_mv | 10.1016/j.transproceed.2015.05.007 |
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Methods We conducted quantitative real-time polymerase chain reaction (PCR) assays of CMV on plasma samples of 1,168 patients in Kuwait who received solid organ transplants from 2012 to 2014 to detect and monitor CMV DNA viral load. Results Of the 1,168 patients, 180 (15.4%) were positive for CMV DNA. Among the CMV DNA–positive patients, 119 (66.1%) remained without symptoms and 61 (33.9%) developed CMV-related symptoms. During the follow-up period, peak viral loads were significantly ( P < .05) higher in symptomatic patients (mean 970 copies/mL; range, 15–625,000 copies/mL) than in asymptomatic patients (<150 copies/mL; range, 67–2,650 copies/mL). Many symptomatic patients ( n = 57) were successfully treated, and their viral loads declined. However, some symptomatic patients had irregular viral-load kinetics, with prolonged periods of symptoms despite CMV treatment; we excluded the possibility of drug resistance in these patients, because there was no evidence of clinical resistance to treatment. Conclusions Quantitative real-time PCR of CMV DNA is useful in monitoring CMV infection and the effectiveness of CMV treatment in renal transplant recipients in Kuwait.</description><identifier>ISSN: 0041-1345</identifier><identifier>EISSN: 1873-2623</identifier><identifier>DOI: 10.1016/j.transproceed.2015.05.007</identifier><identifier>PMID: 26293054</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Cytomegalovirus - genetics ; Cytomegalovirus Infections - diagnosis ; Cytomegalovirus Infections - epidemiology ; Cytomegalovirus Infections - virology ; Disease Management ; DNA, Viral - analysis ; Female ; Humans ; Incidence ; Kuwait - epidemiology ; Male ; Middle Aged ; Organ Transplantation ; Real-Time Polymerase Chain Reaction ; Surgery ; Viral Load - utilization</subject><ispartof>Transplantation proceedings, 2015-07, Vol.47 (6), p.1802-1807</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-7dbcff3d4dbe2c18b900df463863a4a39c01a8a73b7bb61436d92b0a5623d7a63</citedby><cites>FETCH-LOGICAL-c435t-7dbcff3d4dbe2c18b900df463863a4a39c01a8a73b7bb61436d92b0a5623d7a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.transproceed.2015.05.007$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26293054$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Madi, N</creatorcontrib><creatorcontrib>Al-Qaser, M</creatorcontrib><creatorcontrib>Edan, R</creatorcontrib><creatorcontrib>Al-Nakib, W</creatorcontrib><title>Clinical Utility of Viral Load in the Management of Cytomegalovirus Infection in Solid Organ Transplant Patients in Kuwait</title><title>Transplantation proceedings</title><addtitle>Transplant Proc</addtitle><description>Abstract Background Infection with human cytomegalovirus (CMV) in solid organ transplant patients remains an unresolved challenge, despite improvements in immunosuppressive therapy, post-transplantation care, viral prevention, and therapy. Methods We conducted quantitative real-time polymerase chain reaction (PCR) assays of CMV on plasma samples of 1,168 patients in Kuwait who received solid organ transplants from 2012 to 2014 to detect and monitor CMV DNA viral load. Results Of the 1,168 patients, 180 (15.4%) were positive for CMV DNA. Among the CMV DNA–positive patients, 119 (66.1%) remained without symptoms and 61 (33.9%) developed CMV-related symptoms. During the follow-up period, peak viral loads were significantly ( P < .05) higher in symptomatic patients (mean 970 copies/mL; range, 15–625,000 copies/mL) than in asymptomatic patients (<150 copies/mL; range, 67–2,650 copies/mL). Many symptomatic patients ( n = 57) were successfully treated, and their viral loads declined. However, some symptomatic patients had irregular viral-load kinetics, with prolonged periods of symptoms despite CMV treatment; we excluded the possibility of drug resistance in these patients, because there was no evidence of clinical resistance to treatment. Conclusions Quantitative real-time PCR of CMV DNA is useful in monitoring CMV infection and the effectiveness of CMV treatment in renal transplant recipients in Kuwait.</description><subject>Adult</subject><subject>Cytomegalovirus - genetics</subject><subject>Cytomegalovirus Infections - diagnosis</subject><subject>Cytomegalovirus Infections - epidemiology</subject><subject>Cytomegalovirus Infections - virology</subject><subject>Disease Management</subject><subject>DNA, Viral - analysis</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kuwait - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Organ Transplantation</subject><subject>Real-Time Polymerase Chain Reaction</subject><subject>Surgery</subject><subject>Viral Load - utilization</subject><issn>0041-1345</issn><issn>1873-2623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkl1rFDEUhoModlv9CxK88mbWk4-Z7HghyKq1uFKhrbchk2TWrDNJm2Qq6683425BvBIOhOS87zknT4LQSwJLAqR5vVvmqHy6jUFba5YUSL2EEiAeoQVZCVbRhrLHaAHASUUYr0_QaUo7KHvK2VN0UvItg5ov0K_14LzTasA32Q0u73Ho8TcXy8EmKIOdx_m7xV-UV1s7Wp_n_Hqfw2i3agj3Lk4JX_je6uyCn-VXYXAGX8at8vj6z5yDKravKrtiT7Pk8_RTufwMPenVkOzz43qGbj5-uF5_qjaX5xfrd5tKc1bnSphO9z0z3HSWarLqWgDT84atGqa4Yq0GolZKsE50XUM4a0xLO1B1YWCEatgZenWoW4DdTTZlObqk7VDGsmFKkghoKAgq2iJ9c5DqGFKKtpe30Y0q7iUBObOXO_k3ezmzl1ACRDG_OPaZurHkHqwPsIvg_UFgy23vnY0y6cJEW-Ni4SdNcP_X5-0_ZfTxDX_YvU27MEVfeEoiE5Ugr-ZfMH8CUgPUlAj2G2AZssU</recordid><startdate>20150701</startdate><enddate>20150701</enddate><creator>Madi, N</creator><creator>Al-Qaser, M</creator><creator>Edan, R</creator><creator>Al-Nakib, W</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150701</creationdate><title>Clinical Utility of Viral Load in the Management of Cytomegalovirus Infection in Solid Organ Transplant Patients in Kuwait</title><author>Madi, N ; Al-Qaser, M ; Edan, R ; Al-Nakib, W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-7dbcff3d4dbe2c18b900df463863a4a39c01a8a73b7bb61436d92b0a5623d7a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Cytomegalovirus - genetics</topic><topic>Cytomegalovirus Infections - diagnosis</topic><topic>Cytomegalovirus Infections - epidemiology</topic><topic>Cytomegalovirus Infections - virology</topic><topic>Disease Management</topic><topic>DNA, Viral - analysis</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kuwait - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Organ Transplantation</topic><topic>Real-Time Polymerase Chain Reaction</topic><topic>Surgery</topic><topic>Viral Load - utilization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Madi, N</creatorcontrib><creatorcontrib>Al-Qaser, M</creatorcontrib><creatorcontrib>Edan, R</creatorcontrib><creatorcontrib>Al-Nakib, W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Transplantation proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Madi, N</au><au>Al-Qaser, M</au><au>Edan, R</au><au>Al-Nakib, W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Utility of Viral Load in the Management of Cytomegalovirus Infection in Solid Organ Transplant Patients in Kuwait</atitle><jtitle>Transplantation proceedings</jtitle><addtitle>Transplant Proc</addtitle><date>2015-07-01</date><risdate>2015</risdate><volume>47</volume><issue>6</issue><spage>1802</spage><epage>1807</epage><pages>1802-1807</pages><issn>0041-1345</issn><eissn>1873-2623</eissn><abstract>Abstract Background Infection with human cytomegalovirus (CMV) in solid organ transplant patients remains an unresolved challenge, despite improvements in immunosuppressive therapy, post-transplantation care, viral prevention, and therapy. Methods We conducted quantitative real-time polymerase chain reaction (PCR) assays of CMV on plasma samples of 1,168 patients in Kuwait who received solid organ transplants from 2012 to 2014 to detect and monitor CMV DNA viral load. Results Of the 1,168 patients, 180 (15.4%) were positive for CMV DNA. Among the CMV DNA–positive patients, 119 (66.1%) remained without symptoms and 61 (33.9%) developed CMV-related symptoms. During the follow-up period, peak viral loads were significantly ( P < .05) higher in symptomatic patients (mean 970 copies/mL; range, 15–625,000 copies/mL) than in asymptomatic patients (<150 copies/mL; range, 67–2,650 copies/mL). Many symptomatic patients ( n = 57) were successfully treated, and their viral loads declined. However, some symptomatic patients had irregular viral-load kinetics, with prolonged periods of symptoms despite CMV treatment; we excluded the possibility of drug resistance in these patients, because there was no evidence of clinical resistance to treatment. Conclusions Quantitative real-time PCR of CMV DNA is useful in monitoring CMV infection and the effectiveness of CMV treatment in renal transplant recipients in Kuwait.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26293054</pmid><doi>10.1016/j.transproceed.2015.05.007</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Cytomegalovirus - genetics Cytomegalovirus Infections - diagnosis Cytomegalovirus Infections - epidemiology Cytomegalovirus Infections - virology Disease Management DNA, Viral - analysis Female Humans Incidence Kuwait - epidemiology Male Middle Aged Organ Transplantation Real-Time Polymerase Chain Reaction Surgery Viral Load - utilization |
| title | Clinical Utility of Viral Load in the Management of Cytomegalovirus Infection in Solid Organ Transplant Patients in Kuwait |
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