Detection of viruses in the peritoneum of the Iranian patients on peritoneal dialysis

Abstract

Despite reductions in overall infectious peritonitis rate due to improvement in peritoneal dialysis (PD) systems, peritonitis is still a major complication of PD and a major cause of failure of this method of dialysis. In this context, viral infections have rarely been investigated, although up to 20% of cases remain culture negative (non-bacterial, non-fungal). The present study aimed to screen stored PD effluent samples for viral infection to assess the incidence in a cross-sectional cohort of patients on PD. Nucleic acid extracted from PD samples (n=205) were analysed using either conventional polymerase chain reaction (PCR) or real-time PCR for polyomaviruses (JCV, BKV, KIV, WUV, MCV, SV40, and LPV), human cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex viruses (HSV-1 and 2), varicella-zoster virus, adenoviruses, enteroviruses, parechovirus and human norovirus. Of the 205 PD effluent samples analysed, 10 (4.8%) were found to be positive for viral infections (BKV: 2.9%; CMV: 1.9%). One out of ten positive patients were clinically well at the time of PD effluent collection although five patients who tested positively for CMV or BKV was diagnosed with sterile peritonitis. This study has described that BKV and CMV may be present in the peritoneum of patients on PD. BKV and CMV should be considered as a potential cause of aseptic peritonitis in patients on PD. Key words: Peritoneal dialysis (PD), peritonitis, polymerase chain reaction (PCR), BK polyomavirus, cytomegalovirus (CMV).