A Study of Viral Infections in Renal Transplant Recipients Risk Factors, Clinical Profile And Outcome Analysis

Abstract

Introduction: Renal transplantation has become the most effective means of rehabilitating patients with end stage renal disease. In well-established centers, 90% 1 year graft survival and 95% patient survival is achieved. In spite of this, infection occurs more than 60% of renal transplant recipients and being the one of the main cause of death in renal transplant recipients. If the net state of immunosuppression is minimal then an overwhelming exposure only causes the disease. . Routine antimicrobiologic prophylaxis is aimed at common infection i.e. That includes trimethoprim-sulphamethoxazole (toxoplasmosis , pneumocystis, Nocardia, UTI) and valganciclovir( CMV and herpes groups) and antifungal (Kidney-pancreas transplantation). In this study, attempt has been made to analyze the risk factors, clinical profile and outcome of viral infection in renal transplant recipient. Methods: It is a cross-sectional, descriptive, prospective and retrospective study of 356 patients conducted in the department of Nephrology. Renal transplant recipients diagnosed with viral infections were included in the study. Results: Bacterial, viral, fungal and parasitic infection contributes to 45%,30.5%,9.5%,5.3% respectively to the total infective episodes. Most of the viral episodes occurred after 6 months post-transplant. Commonest viral infection is the CMV and its prevalence 17.4% and mean time of onset is between 1-6 months after transplantation. On Univariate analysis, antirejection therapy and NODAT had statistical significant risk factor for developing viral infection (P<0.05). In patients affected with viral infection on univariate analysis, there is a statistical significance for graft dysfunction, graft loss and death (P<0.05). CMV infection has a statistical significant risk factor for bacterial, fungal and other viral infections. (P<0.05). Hepatitis C infection is the second most common virus found in our study. The mean onset of infection is seen 6 months after transplant. Nearly 50% HCV infected patients developed NODAT. Conclusion: The clinical profile of the patients in post renal transplant cases is studied. In this study, attempt has been made to analyze the risk factors and outcome of viral infection in renal transplant recipient.