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Epidemiology and morbidity of Epstein-Barr virus infection in pediatric renal transplant recipients: a multicenter, prospective study

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Epidemiology and morbidity of Epstein-Barr virus infection in pediatric renal transplant recipients: a multicenter, prospective study. / Höcker, Britta; Fickenscher, Helmut; Delecluse, Henri-Jacques; Böhm, Stephan; Küsters, Uta; Schnitzler, Paul; Pohl, Martin; John, Ulrike; Kemper, Markus J; Fehrenbach, Henry; Wigger, Marianne; Holder, Martin; Schröder, Monika; Billing, Heiko; Fichtner, Alexander; Feneberg, Reinhard; Sander, Anja; Köpf-Shakib, Sabine; Süsal, Caner; Tönshoff, Burkhard.

In: CLIN INFECT DIS, Vol. 56, No. 1, 1, 2013, p. 84-92.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Höcker, B, Fickenscher, H, Delecluse, H-J, Böhm, S, Küsters, U, Schnitzler, P, Pohl, M, John, U, Kemper, MJ, Fehrenbach, H, Wigger, M, Holder, M, Schröder, M, Billing, H, Fichtner, A, Feneberg, R, Sander, A, Köpf-Shakib, S, Süsal, C & Tönshoff, B 2013, 'Epidemiology and morbidity of Epstein-Barr virus infection in pediatric renal transplant recipients: a multicenter, prospective study', CLIN INFECT DIS, vol. 56, no. 1, 1, pp. 84-92. https://doi.org/10.1093/cid/cis823

APA

Höcker, B., Fickenscher, H., Delecluse, H-J., Böhm, S., Küsters, U., Schnitzler, P., Pohl, M., John, U., Kemper, M. J., Fehrenbach, H., Wigger, M., Holder, M., Schröder, M., Billing, H., Fichtner, A., Feneberg, R., Sander, A., Köpf-Shakib, S., Süsal, C., & Tönshoff, B. (2013). Epidemiology and morbidity of Epstein-Barr virus infection in pediatric renal transplant recipients: a multicenter, prospective study. CLIN INFECT DIS, 56(1), 84-92. [1]. https://doi.org/10.1093/cid/cis823

Vancouver

Höcker B, Fickenscher H, Delecluse H-J, Böhm S, Küsters U, Schnitzler P et al. Epidemiology and morbidity of Epstein-Barr virus infection in pediatric renal transplant recipients: a multicenter, prospective study. CLIN INFECT DIS. 2013;56(1):84-92. 1. https://doi.org/10.1093/cid/cis823

Bibtex

@article{4ed7aa3cd7eb42ec91d5364f4104a2a0,
title = "Epidemiology and morbidity of Epstein-Barr virus infection in pediatric renal transplant recipients: a multicenter, prospective study",
abstract = "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.",
keywords = "Humans, Male, Female, Adolescent, Prospective Studies, Child, Viral Load, Statistics, Nonparametric, Analysis of Variance, Immunosuppressive Agents/therapeutic use, Morbidity, Antiviral Agents/therapeutic use, Epstein-Barr Virus Infections/*epidemiology/immunology/therapy/virology, Graft Rejection/drug therapy/prevention & control, Herpesvirus 4, Human/immunology/*isolation & purification, Kidney Transplantation/*statistics & numerical data, Lymphoproliferative Disorders/epidemiology/etiology/virology, Transplants/statistics & numerical data, Humans, Male, Female, Adolescent, Prospective Studies, Child, Viral Load, Statistics, Nonparametric, Analysis of Variance, Immunosuppressive Agents/therapeutic use, Morbidity, Antiviral Agents/therapeutic use, Epstein-Barr Virus Infections/*epidemiology/immunology/therapy/virology, Graft Rejection/drug therapy/prevention & control, Herpesvirus 4, Human/immunology/*isolation & purification, Kidney Transplantation/*statistics & numerical data, Lymphoproliferative Disorders/epidemiology/etiology/virology, Transplants/statistics & numerical data",
author = "Britta H{\"o}cker and Helmut Fickenscher and Henri-Jacques Delecluse and Stephan B{\"o}hm and Uta K{\"u}sters and Paul Schnitzler and Martin Pohl and Ulrike John and Kemper, {Markus J} and Henry Fehrenbach and Marianne Wigger and Martin Holder and Monika Schr{\"o}der and Heiko Billing and Alexander Fichtner and Reinhard Feneberg and Anja Sander and Sabine K{\"o}pf-Shakib and Caner S{\"u}sal and Burkhard T{\"o}nshoff",
year = "2013",
doi = "10.1093/cid/cis823",
language = "English",
volume = "56",
pages = "84--92",
journal = "CLIN INFECT DIS",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "1",

}

RIS

TY - JOUR

T1 - Epidemiology and morbidity of Epstein-Barr virus infection in pediatric renal transplant recipients: a multicenter, prospective study

AU - Höcker, Britta

AU - Fickenscher, Helmut

AU - Delecluse, Henri-Jacques

AU - Böhm, Stephan

AU - Küsters, Uta

AU - Schnitzler, Paul

AU - Pohl, Martin

AU - John, Ulrike

AU - Kemper, Markus J

AU - Fehrenbach, Henry

AU - Wigger, Marianne

AU - Holder, Martin

AU - Schröder, Monika

AU - Billing, Heiko

AU - Fichtner, Alexander

AU - Feneberg, Reinhard

AU - Sander, Anja

AU - Köpf-Shakib, Sabine

AU - Süsal, Caner

AU - Tönshoff, Burkhard

PY - 2013

Y1 - 2013

N2 - 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.

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.

KW - Humans

KW - Male

KW - Female

KW - Adolescent

KW - Prospective Studies

KW - Child

KW - Viral Load

KW - Statistics, Nonparametric

KW - Analysis of Variance

KW - Immunosuppressive Agents/therapeutic use

KW - Morbidity

KW - Antiviral Agents/therapeutic use

KW - Epstein-Barr Virus Infections/epidemiology/immunology/therapy/virology

KW - Graft Rejection/drug therapy/prevention & control

KW - Herpesvirus 4, Human/immunology/isolation & purification

KW - Kidney Transplantation/statistics & numerical data

KW - Lymphoproliferative Disorders/epidemiology/etiology/virology

KW - Transplants/statistics & numerical data

KW - Humans

KW - Male

KW - Female

KW - Adolescent

KW - Prospective Studies

KW - Child

KW - Viral Load

KW - Statistics, Nonparametric

KW - Analysis of Variance

KW - Immunosuppressive Agents/therapeutic use

KW - Morbidity

KW - Antiviral Agents/therapeutic use

KW - Epstein-Barr Virus Infections/epidemiology/immunology/therapy/virology

KW - Graft Rejection/drug therapy/prevention & control

KW - Herpesvirus 4, Human/immunology/isolation & purification

KW - Kidney Transplantation/statistics & numerical data

KW - Lymphoproliferative Disorders/epidemiology/etiology/virology

KW - Transplants/statistics & numerical data

U2 - 10.1093/cid/cis823

DO - 10.1093/cid/cis823

M3 - SCORING: Journal article

C2 - 23042966

VL - 56

SP - 84

EP - 92

JO - CLIN INFECT DIS

JF - CLIN INFECT DIS

SN - 1058-4838

IS - 1

M1 - 1

ER -