Background We performed serological and molecular pretransplant screening in solid organ transplant (SOT) donors and recipients in north central Italy and a surveillance program for human herpesvirus 8 (HHV8) infection after transplant, aiming to establish an optimal management of HHV8 infection in SOT recipients. Methods For pretransplant HHV8 screening in both donors and recipients, 6 serological (4 indirect immunofluorescent assays [IFA] and 2 enzyme-linked immunosorbent assays-both HHV8 lytic and latent antigen based) and 2 molecular assays were used. A reference standard to identify HHV8-positive patients was defined by at least 2 positive assays. All transplant patients at risk to develop HHV8-related disease underwent virological posttransplant monitoring by quantitative real-time polymerase chain reaction (PCR) assay. Results Human herpesvirus 8 seroprevalence was 4% (10/249) in donors and 18% (93/517) in organ recipients. The best performance was obtained by 2 lytic antigen-based IFAs that showed almost perfect agreement to the reference standard (0.943 and 0.931 Cohen kappa). Human herpesvirus 8-DNA was detected in 6.8% and 2.9% of HHV8-seropositive donor samples by in-house nested PCR and quantitative real-time PCR assays, respectively. After transplant, 3 (25%) of 12 HHV8-mismatch patients (seropositive donor/seronegative recipient) developed a primary infection, one of whom developed a lethal nonmalignant illness. Two of 93 HHV8-seropositive recipients (2.1%) had viral replication in posttransplant period, one of whom developed Kaposi sarcoma. Conclusions Serological assays, specifically lytic IFAs, were the best methodological approach to identify HHV8-infected SOT donors and recipients. A very low incidence (1.9%) of posttransplant HHV8-related disease was observed.

Multicenter Prospective Study for Laboratory Diagnosis of HHV8 Infection in Solid Organ Donors and Transplant Recipients and Evaluation of the Clinical Impact after Transplantation / Chiereghin, Angela; Barozzi, Patrizia; Petrisli, Evangelia; Piccirilli, Giulia; Gabrielli, Liliana; Riva, Giovanni; Potenza, Leonardo; Cappelli, Gianni; De Ruvo, Nicola; Libri, Irene; Maggiore, Umberto; Morelli, Maria Cristina; Potena, Luciano; Todeschini, Paola; Gibertoni, Dino; Labanti, Manuel; Sangiorgi, Gabriela; La Manna, Gaetano; Pinna, Antonio Daniele; Luppi, Mario; Lazzarotto, Tiziana. - In: TRANSPLANTATION. - ISSN 0041-1337. - 101:8(2017), pp. 1935-1944. [10.1097/TP.0000000000001740]

Multicenter Prospective Study for Laboratory Diagnosis of HHV8 Infection in Solid Organ Donors and Transplant Recipients and Evaluation of the Clinical Impact after Transplantation

CAPPELLI, GIANNI;LIBRI, Irene;Maggiore, Umberto;La Manna, Gaetano;
2017

Abstract

Background We performed serological and molecular pretransplant screening in solid organ transplant (SOT) donors and recipients in north central Italy and a surveillance program for human herpesvirus 8 (HHV8) infection after transplant, aiming to establish an optimal management of HHV8 infection in SOT recipients. Methods For pretransplant HHV8 screening in both donors and recipients, 6 serological (4 indirect immunofluorescent assays [IFA] and 2 enzyme-linked immunosorbent assays-both HHV8 lytic and latent antigen based) and 2 molecular assays were used. A reference standard to identify HHV8-positive patients was defined by at least 2 positive assays. All transplant patients at risk to develop HHV8-related disease underwent virological posttransplant monitoring by quantitative real-time polymerase chain reaction (PCR) assay. Results Human herpesvirus 8 seroprevalence was 4% (10/249) in donors and 18% (93/517) in organ recipients. The best performance was obtained by 2 lytic antigen-based IFAs that showed almost perfect agreement to the reference standard (0.943 and 0.931 Cohen kappa). Human herpesvirus 8-DNA was detected in 6.8% and 2.9% of HHV8-seropositive donor samples by in-house nested PCR and quantitative real-time PCR assays, respectively. After transplant, 3 (25%) of 12 HHV8-mismatch patients (seropositive donor/seronegative recipient) developed a primary infection, one of whom developed a lethal nonmalignant illness. Two of 93 HHV8-seropositive recipients (2.1%) had viral replication in posttransplant period, one of whom developed Kaposi sarcoma. Conclusions Serological assays, specifically lytic IFAs, were the best methodological approach to identify HHV8-infected SOT donors and recipients. A very low incidence (1.9%) of posttransplant HHV8-related disease was observed.
Multicenter Prospective Study for Laboratory Diagnosis of HHV8 Infection in Solid Organ Donors and Transplant Recipients and Evaluation of the Clinical Impact after Transplantation / Chiereghin, Angela; Barozzi, Patrizia; Petrisli, Evangelia; Piccirilli, Giulia; Gabrielli, Liliana; Riva, Giovanni; Potenza, Leonardo; Cappelli, Gianni; De Ruvo, Nicola; Libri, Irene; Maggiore, Umberto; Morelli, Maria Cristina; Potena, Luciano; Todeschini, Paola; Gibertoni, Dino; Labanti, Manuel; Sangiorgi, Gabriela; La Manna, Gaetano; Pinna, Antonio Daniele; Luppi, Mario; Lazzarotto, Tiziana. - In: TRANSPLANTATION. - ISSN 0041-1337. - 101:8(2017), pp. 1935-1944. [10.1097/TP.0000000000001740]
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11381/2857893
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