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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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