Interrelationships among quantity of human cytomegalovirus (HCMV) DNA in blood, donor-recipient serostatus, and administration of methylprednisolone as risk factors for HCMV disease following liver transplantation
Interrelationships among quantity of human cytomegalovirus (HCMV) DNA in blood, donor-recipient serostatus, and administration of methylprednisolone as risk factors for HCMV disease following liver transplantation
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DOI：
10.1086/514145
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发表时间：
1997-12-01
影响因子：
6.4
通讯作者：
Emery, VC
中科院分区：
文献类型：
--
作者：
Cope, AV;Sabin, C;Emery, VC
对162例肝移植受者的纵向分析发现，51例患者存在病毒血症。采用定量竞争聚合酶链反应测定其中47例患者的病毒载量，20例有症状患者的病毒载量峰值显著高于27例无症状患者（P < 0.0001），病毒载量升高、供体血清阳性和甲泼尼龙总剂量是人巨细胞病毒（HCMV）病的危险因素(优势比[OR]，病毒载量增加2.22/0.25 log(10), P = .001；或4.11,p = 0.05；OR，甲基强的松龙剂量增加130/1 g， P = 0.01)、甲基强的松龙和病毒载量是多因素分析中的独立危险因素（OR， 2.70/1 g增加，P = 0.003； OR, 1.61/0.25 log（10）增加，P = 0.03）。10(4.75)-10（5.25）个基因组/mL血液的病毒载量与疾病概率增加相关；随着甲基强的松龙剂量的增加，后者转移到较低的病毒载量。这些数据说明了病毒载量在HCMV发病机制中的核心作用。
Longitudinal analysis of 162 liver transplant recipients identified 51 patients who were viremic. Virus load was determined in 47 of these patients using quantitative-competitive polymerase chain reaction, Peak: virus load was significantly higher in 20 symptomatic patients than 27 asymptomatic patients (P < .0001), Elevated virus load, donor seropositivity, and total methylprednisolone dosage were risk factors for human cytomegalovirus (HCMV) disease (odds ratio [OR], 2.22/0.25 log(10) increase in virus load, P = .001; OR, 4.11, P = .05; OR, 130/1-g increment in methylprednisolone, P = .01), Methylprednisolone and virus load were independent risk factors in a multivariate analysis (OR, 2.70/1-g increase, P = .003; OR, 1.61/0.25 log(10) increase, P = .03, respectively). Virus loads of 10(4.75)-10(5.25) genomes/mL of blood were associated with an increased disease probability; the latter was shifted to lower virus loads with increasing quantities of methylprednisolone. These data illustrate the central role of virus load in HCMV pathogenesis.