Abstract
BackgroundHuman cytomegalovirus (HCMV) can cause poor outcomes in solid organ transplant (SOT) recipients; moreover, it is associated with cardiovascular diseases (CVD) in the general population. Accordingly, anti-HCMV immunoglobulin G (IgG) seroepidemiology may be useful in identifying the risk of post-SOT HCMV infection or disease as well as immunosenescence or CVD. However, HCMV seroprevalence and titre have not been fully evaluated with regard to age distribution or compared between SOT recipients and healthy individuals in South Korea.MethodsWe retrospectively retrieved all unduplicated anti-HCMV IgG results of individuals aged > 1 year evaluated between July 2006 and November 2017 at Severance Hospital in Seoul. The cohort, excluding haematopoietic stem cell transplant recipients and subjects with equivocal values, included 2184 SOT recipients and 3015 healthy transplant donors. All IgG results in the SOT recipients were measured during the pre-transplant period.ResultsThe overall IgG seroprevalence and titres were significantly higher among SOT recipients than among healthy donors (98.7% vs. 88.6%, p < 0.001, and 64.7 ± 44.3 vs. 49.8 ± 20.6 arbitrary units/mL, p < 0.001, respectively). The lowest seropositive rate in the SOT group was observed in recipients aged between 11 and 15 years (70.6%). The frequency of seropositivity among adults aged ≥41 years increased to ≥90% in SOT recipients and healthy donors. Age was independently associated with higher HCMV seroprevalence (41–60 years, OR, 76.4, 95% CI, 24.5–238.9, p < 0.001; ≥ 61 years, OR, 4.4, 95% CI, 1.3–14.9, p < 0.001, compared to ≤40 years). The healthy donor group had an independently low HCMV seropositive rate (OR, 0.1, 95% CI, 0.1–0.2, p < 0.001).ConclusionsHCMV seropositivity was the lowest among school-aged children and adolescents. IgG testing revealed an intermediate serostatus risk of post-transplant HCMV infection and disease for most adult SOT recipients in South Korea.
Highlights
Human cytomegalovirus (HCMV) can cause poor outcomes in solid organ transplant (SOT) recipients; it is associated with cardiovascular diseases (CVD) in the general population
The frequency of anti-HCMV immunoglobulin G (IgG) positivity in all ages was significantly higher among SOT recipients than among healthy transplant donors (98.7% vs. 88.6%, p < 0.001) (Table 1)
HCMV seroprevalence according to age groups There were few subjects aged ≤15 years in the SOT recipients group (44/2184, 2.0%) and none in the group of 3015 healthy transplant donors
Summary
Human cytomegalovirus (HCMV) can cause poor outcomes in solid organ transplant (SOT) recipients; it is associated with cardiovascular diseases (CVD) in the general population. The complicated mechanisms involved in the latent-to-lytic switch can induce temporary or sustained HCMV replication, leading to active cytolytic inflammation [1, 3, 4]. In both immunocompetent and immunocompromised patients, reactivation of latent HCMV can result in direct tissue damage that causes end organ disease [1, 5,6,7]. The pre-transplant HCMV serostatus in donors and recipients is an important factor predicting post-transplant HCMV infection and disease; it provides information that would be useful in developing individually tailored anti-HCMV preventive strategies for SOT recipients [1, 3, 9, 16, 17]
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