IL28B rs12979860 T allele protects against CMV disease in liver transplant recipients in the post-prophylaxis and late period.

Abstract

Cytomegalovirus (CMV) disease represents a serious complication in liver transplant (OLT) recipients. CMV prophylaxis reduces incidence of CMV disease in the early post-transplant period (on-prophylaxis disease, OPD) but may postpone its manifestation after the completion of prophylaxis. Post-prophylaxis disease (PPD) incidence after prophylaxis cessation may be modified by genetic factors. We analyzed impact of IL28B rs1297986 variants on CMV disease incidence in 743 adult OLT recipients receiving universal prophylaxis. One hundred and forty-four (19.4%) patients had at least one CMV disease episode. One hundred and two of them (70.8%) had at least one OPD and 36 (25%) patients had PPD, six (4.2%) patients had both. The rate of IL28B T allele carriers was lower in PPD group (38.9%) in comparison with OPD group (66.7%, P=0.005) and group without CMV disease (61.4%, P=0.009). The impact of IL28B genotype on the risk of CMV OPD was significant neither in the allelic (TT+CT vs CC, P=0.32) nor in the recessive model (TT vs CT+CC, P=0.79). Contrarily, in the PPD group, T allele (TT+CT vs CC) had a protective effect, OR 0.4 (95% CI 0.2-0.8, P=0.008). Further risk factors of PPD were age <55years and valganciclovir prophylaxis, whereas the risk factors of OPD were age <55years, cyclosporine A therapy and pre-transplant CMV serostatus (donor +/recipient -). IL28B rs12979860 T allele carriers had a lower risk of CMV PPD.