Article ; Online: KIR and Human Leukocyte Antigen Genotype Associated Risk of Cytomegalovirus Disease in Renal Transplant Patients.
2015 Volume 99, Issue 7, Page(s) 1506–1513
Abstract: Background: Cytomegalovirus(CMV) infections have a significant effect on morbidity and mortality in kidney transplants. We conducted a study to ascertain the association of natural killer cell killer immunoglobulin-like receptors and human leukocyte ... ...
| Abstract | Background: Cytomegalovirus(CMV) infections have a significant effect on morbidity and mortality in kidney transplants. We conducted a study to ascertain the association of natural killer cell killer immunoglobulin-like receptors and human leukocyte antigen (HLA) genotype with risk of CMV disease. Methods: The 90 CMV-negative patients receiving a first renal transplantation from a CMV-positive donor in this study received triple immunosuppressive therapy and prophylactic CMV treatment for up to 3 months after transplantation. Results: We observed a 43.3% incidence rate of CMV disease within the first year after transplantation. Twenty-seven recipients experienced a rejection episode, 14 of which had CMV disease, mostly after rejection, suggesting that in this group, CMV disease is not a risk factor for rejection. KIR gene or genotype distribution were similar between the CMV diseased and CMV disease-free group. Twenty-seven recipients (30%) carried KIR-AA genotype, of which nine (33%) had CMV disease. Of the remaining 63 (70%) recipients with KIR-BX genotype, 30 (48%) had CMV disease. There was no significant difference between the two genotype groups with regard to occurrence of CMV disease, although there was a trend toward a lower incidence of CMV disease in recipients carrying the KIR-AA genotype. For CMV disease, we found no significant risk associated with the number of activating or inhibitory KIRs. Neither was missing KIR ligands for the inhibitory KIRs (HLA-C1/C2/Bw4) in recipients associated with lower rates of CMV disease. Conclusion: In CMV-negative recipients, genotypic analysis of KIR repertoire and HLA ligands does not provide risk factors for primary CMV disease after renal transplantation. |
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| MeSH term(s) | Adult ; Antiviral Agents/administration & dosage ; Cytomegalovirus Infections/epidemiology ; Cytomegalovirus Infections/genetics ; Cytomegalovirus Infections/immunology ; Cytomegalovirus Infections/prevention & control ; Cytomegalovirus Infections/virology ; Drug Therapy, Combination ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Graft Rejection/epidemiology ; Graft Rejection/genetics ; Graft Rejection/immunology ; HLA Antigens/genetics ; HLA Antigens/immunology ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/adverse effects ; Incidence ; Kidney Transplantation/adverse effects ; Male ; Middle Aged ; Phenotype ; Receptors, KIR/genetics ; Receptors, KIR/immunology ; Risk Factors ; Time Factors ; Treatment Outcome |
| Chemical Substances | Antiviral Agents ; HLA Antigens ; Immunosuppressive Agents ; Receptors, KIR |
| Language | English |
| Publishing date | 2015-07 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 208424-7 |
| ISSN | 1534-6080 ; 0041-1337 |
| ISSN (online) | 1534-6080 |
| ISSN | 0041-1337 |
| DOI | 10.1097/TP.0000000000000497 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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