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Journal of Clinical Microbiology, February 2000, p. 613-619, Vol. 38, No. 2
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

High Levels of Epstein-Barr Virus DNA in Blood of Solid-Organ Transplant Recipients and Their Value in Predicting Posttransplant Lymphoproliferative Disorders

Fausto Baldanti,1,2 Paolo Grossi,3 Milena Furione,1 Lavinia Simoncini,1 Antonella Sarasini,1 Patrizia Comoli,4 Rita Maccario,4 Roberto Fiocchi,5 and Giuseppe Gerna1,*

Servizio di Virologia,1 Laboratori Sperimentali di Ricerca,2 Istituto di Malattie Infettive,3 and Clinica Pediatrica,4 Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Università di Pavia, 27100 Pavia, and Divisione di Cardiochirurgia, Ospedali Riuniti, 24100 Bergamo,5 Italy

Received 12 May 1999/Returned for modification 11 August 1999/Accepted 1 November 1999

Epstein-Barr virus (EBV) DNA was quantitated in peripheral blood mononuclear cells (PBMC) from 25 healthy subjects, 105 asymptomatic solid-organ transplant (SOT) recipients, and 15 SOT recipients with symptomatic EBV infections by using a newly developed quantitative-PCR technique. Patients with symptomatic EBV infections had significantly higher (P < 0.001) median EBV DNA levels than asymptomatic SOT recipients and immunocompetent individuals. In SOT recipients, the positive predictive value of EBV DNA levels of >1,000 genome equivalents (GE)/0.5 µg of total PBMC DNA was 64.7% for symptomatic EBV infection, while the negative predictive value was 96.1%. In 19 of 32 (59.3%) asymptomatic SOT recipients, EBV DNA levels were consistently below 1,000 GE for as long as 18 months, while 10 of 32 (31.2%) patients had 1,000 to 5,000 EBV GE at least once during follow-up. In a minority of patients (3 of 32; 9.3%), >= 5,000 GE could be detected at least once during follow-up. Reduction of immunosuppressive treatment decreased EBV DNA levels by >= 1 log10 unit in patients with symptomatic EBV infections. Quantification of EBV DNA is valuable for the diagnosis and monitoring of symptomatic EBV infections in SOT recipients.

* Corresponding author. Mailing address: Servizio di Virologia, IRCCS Policlinico San Matteo, 27100 Pavia, Italy. Phone: 39-0382-502644/633. Fax: 39-0382-502599. E-mail: g.gerna{at}smatteo.pv.it or virology{at}ipv36.unipv.it.

Journal of Clinical Microbiology, February 2000, p. 613-619, Vol. 38, No. 2
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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