Cytomegalovirus nosocomial infection following organ transplantation: detection and monitoring

doi:10.3969/j.issn.2095-4344.2015.20.027

Abstract

Abstract:

BACKGROUND: Cytomegalovirus is one of the opportunistic infection viruses for organ transplant patients, and it can lead to functional loss of organ grafts and even endanger lives. Therefore, accurate diagnosis of cytomegalovirus infection at early phase is the key to clinical treatment.
OBJECTIVE: To analyze the detection method, accuracy, detection time and clinical significance of cytomegalovirus infection after organ transplantation.
METHODS: A computer-based search of VIP, PubMed and CNKI as well as manual search of books were performed for literatures concerning organ transplantation and cytomegalovirus infection published from January 2007 to December 2014. The keywords were “transplantation, cytomegalovirus” in English and Chinese, respectively. Total 1 894 papers in English and 31 articles in Chinese were found. Among them, only 35 papers which were highly representative and published in related authoritative journals were chosen for further analysis.
RESULTS AND CONCLUSION: The main non-invasive detection of cytomegalovirus infection is still the test of CMV-pp65 antigen with good sensitivity and specificity which can accurately reflect the status of cytomegalovirus infection. This method is also the most important clinical diagnostic method. Molecular biological detection of cytomegalovirus can detect potentially infected people, and this method can detect the infection earlier than CMV-pp65 antigen method, which is suitable for the early diagnosis of cytomegalovirus infection and early drug treatment. Quantitative nucleic acid test can be used to analyze cytomegalovirus-DNA copies so as to determine the concentrations of the virus in patients, which may provide a more sensitive monitoring way for inapparently infected patients. Cytomegalovirus-IgG and cytomegalovirus-IgM in serum can be used to determine whether organ transplant recipients have been infected by cytomegalovirus. Virus culture and histological examination have been used for several years, both of which are the gold standard for detecting cytomegalovirus. However, these methods cannot be used in early diagnosis and active infection. Immunological detection method provides a new ideal for the diagnosis of cytomegalovirus infection. This method can monitor cytomegalovirus infection from early phase accurately and assess the risk of cytomegalovirus, providing a new way for the development of the diagnosis of cytomegalovirus infection.

Key words: Tissue Engineering, Organ Transplantation, Cytomegalovirus

CLC Number:

R318

Zhang Li-ping, Bai Jian. Cytomegalovirus nosocomial infection following organ transplantation: detection and monitoring [J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2015.20.027 .

Figures/Tables 2

References

[1] Craig JM, Macauley JC, Weller TH, et al. Isolation of intranuclear inclusion producing agents from infants with illnesses resembling cytomegalic inclusion disease. Proc Soc Exp Biol Med. 1957:94(1):4-12.

[2] Ariza-Heredia EJ, Nesher L, Chemaly RF. Cytomegalovirus diseases after hematopoietic stem cell transplantation: a mini-review. Cancer Lett. 2014;342(1):1-8.

[3] Minton K. Viral immunity: How CMV bypasses immune memory. Nat Rev Immunol. 2010;10(5):288.

[4] Bate SL, Dollard SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys 1988–2004. Clin Infect. Dis. 2010;50(11):1439-1447.

[5] 黄云帆,陈虹,王旭,等.肝移植后巨细胞病毒感染:对排斥反应与移植物的影响[J].中国组织工程研究,2014,18(27):443-4428.

[6] Boeckh M. Complications, Diagnosis, Management, and Prevention of CMV Infections: Current and Future. Hematology Am Soc Hematol Educ Program. 2011; 305-309.

[7] Green ML, Leisenring W, Stachel D, et al. Efficacy of a viral load-based, risk-adapted, preemptive treatment strategy for prevention of cytomegalovirus disease after hematopoietic cell transplantation. Biol Blood Marrow Transpl. 2012;18(11): 1687-1699.

[8] Lisboa LF, Asberg A, Kumar D, et al. The clinical utility of whole blood versus plasma cytomegalovirus viral load assays for monitoring therapeutic response. Transplantation. 2011; 91(2):231-236.

[9] Plosa EJ, Esbenshade JC, Fuller MP, et al. Cytomegalovirus Infection. Pediatr Rev. 2012,33(4):156-163.

[10] 杨菁,王东.人巨细胞病毒被膜磷蛋白pp65的检测及其在肾移植受者CMV病诊断中的临床应用[J].南方医科大学学报, 2008, 28(2): 263-265.

[11] Martin JM, Danziger-Isakov LA. Danziger-Isakov2 Cytomegalovirus risk, prevention, and management in pediatric solid organ transplantation. Pediatr Transpl. 2011; 15(3):229-236.

[12] Roman A, Manito N, Campistol JM, et al. The impact of the prevention strategies on the indirect effects of CMV infection in solid organ transplant recipients. Transplant Rev (Orlando). 2014;28:84-89.

[13] 何小舟,许贤林,叶青,等.肾移植后RT-PCR动态检测巨细胞病毒尿的临床意义[J].苏州大学学报(医学版),2007,7(4):591-594.

[14] Hanfler J, Kreuzer KA, Laurisch K, et al. Quantitation of cytomegalovirus (hCMV) DNA and beta-actin DNA by duplex realtime fluorescence PCR in solid organ (liver)transplant recipients. Med Microbiol Inununol. 2003;192(4):197-204.

[15] 周文强,石炳毅,蔡明,等.肾移植后受者人巨细胞病毒巢式PCR检测[J].中国实验诊断学杂志,2007,11(5):628-629.

[16] Stoeher M, Berg J. Normailized quantification of human cytomegalovious DNA by competitive real-time PCR on the Light Cyrcler instrument. J Clin Microbilol. 2002;40(12): 4547-4553.

[17] Mewara A, Mishra B, Ratho RK, et al. Comparison of PCRs for IE-1 and gB genes with ELISA of IgM antibodies for diagnosis of human cytomegalovirus disease. Acta Virol. 2010;54(4):315-316.

[18] Ahmadinejad Z, Ardalan FA, Razzaqi M, et al. QuantiFERON-TB Gold in Tube test for diagnosis of latent tuberculosis (TB) in solid organ transplant candidates: a single-center study in an area endemic for TB. Transpl Infect Dis. 2013;15(1):90-95.

[19] Longworth SA, Vinnard C, Lee I, et al. Risk factors for nontuberculous mycobacterial infections in solid organ transplant recipients: a case-control study. Transpl Infect Dis. 2014;16:76-83.

[20] Giulieri S, Manuel O. QuantiFERON(R)-CMV assay for the assessment of cytomegalovirus cell-mediated immunity. Expert Rev Mol Diagn. 2011;11(1):17-25.

[21] Wiita AP, Roubinian N, Khan Y, et al. Cytomegalovirus disease and infection in lung transplant recipients in the setting of planned indefinite valganciclovir prophylaxis. Transpl Infect Dis. 2012;14(3):248-258.

[22] Ren Y, Ding Q, Zhang X. Ficolins and infectious diseases. Virol Sin. 2014;29(1):25-32.

[23] Wadhawan M, Gupta S, Goyal N, et al. Cytomegalovirus infection: its incidence and management in cytomegalovirus-seropositive living related liver transplant recipients: a single-center experience. Liver Transpl. 2012; 18(12):1448-1455.

[24] Kotton CN. CMV: prevention, diagnosis and therapy. Am J Transpl. 2013;13(s3):24-40.

[25] Hoyo I, Sanclemente G, Cervera C, et al. Opportunistic pulmonary infections in solid organ transplant recipients. Transplant Proc. 2012;44(9):2673-2675.

[26] Blyth E, Clancy L, Simms R, et al. Donor-derived CMVspecific T cells reduce the requirement for CMV-directed pharmacotherapy after allogeneic stem cell transplantation. Blood. 2013;121(18):3745-3758.

[27] Witzke O, Hauser IA, Bartels M, et al. Valganciclovir prophylaxis versus preemptive therapy in cytomegalovirus- positive renal allograft recipients: 1-year results of a randomized clinical trial. Transplantation. 2012;93(1):61-68.

[28] Avkan-Oguz V, Ozkardesler S, Unek T, et al. Risk factors for early bacterial infections in liver transplantation. Transpl Proc. 2013;45(7):993-997.

[29] Emery VC, Asher K, Sanjuan CJ. Importance of the cytomegalovirus seropositive recipient as a contributor to disease burden after solid organ transplantation. J Clin Virol. 2012;54(2):125-129.

[30] Abate D, Saldan A, Mengoli C, et al. Comparison of CMV ELISPOT and CMV QuantiferonTM interferon-c releasing assays in assessing risk of CMV infection in kidney transplant Recipients. J Clin Microbiol. 2013;51(8):2501-2507.

[31] 唐志琴,王玉亮,江雁,等.肝肾移植后巨细胞病毒感染者T细胞表面CD38的动态变化[J].中华微生物学和免疫学杂志, 2006, 26(3): 252-254.

[32] Ticha O, Stouracova M, Kuman M, et al. Monitoring of CD38high expression in peripheral blood CD8+ lymphocytes in patients after kidney transplantation as a marker of cytomegalovirus infection. Transpl Immunol. 2010;24(1): 50-56.

[33] Bestard O, Lucia M, Crespo E, et al. Pretransplant immediately early-1-specific T cell responses provide protection for CMV infection after kidney transplantation. Am J Transplant. 2013;13:1793-1805.

[34] 肖漓,石炳毅,高钰,等.HLA-G与肾移植后巨细胞病毒活动性感染的相关性研究[J].中华器官移植杂志,2011,32(9):534-538.

[35] Clari MA, Munoz-Cobo B, Solano C, et al. Performance of the QuantiFERON-cytomegalovirus (CMV) assay for detection and estimation of the magnitude and functionality of the CMV-specific gamma interferon-producing CD8(+) T-cell response in allogeneic stem cell transplant recipients. Clin Vaccine Immunol. 2012;19(5):791-796.