Ebstein-Barr Virus Research Articles

Direct Ubiquitination of β-Catenin by Siah-1 and Regulation by the Exchange Factor TBL1

Beta-catenin is a key component of the Wnt signaling pathway that functions as a transcriptional co-activator of Wnt target genes. Upon UV-induced DNA damage, beta-catenin is recruited for polyubiquitination and subsequent proteasomal degradation by a unique, p53-induced SCF-like complex (SCF(TBL1)), comprised of Siah-1, Siah-1-interacting protein (SIP), Skp1, transducin beta-like 1 (TBL1), and adenomatous polyposis coli (APC). Given the complexity of the various factors involved and the novelty of ubiquitination of the non-phosphorylated beta-catenin substrate, we have investigated Siah-1-mediated ubiquitination of beta-catenin in vitro and in cells. Overexpression and purification protocols were developed for each of the SCF(TBL1) proteins, enabling a systematic analysis of beta-catenin ubiquitination using an in vitro ubiquitination assay. This study revealed that Siah-1 alone was able to polyubiquitinate beta-catenin. In addition, TBL1 was shown to play a role in protecting beta-catenin from Siah-1 ubiquitination in vitro and from Siah-1-targeted proteasomal degradation in cells. Siah-1 and TBL1 were found to bind to the same armadillo repeat domain of beta-catenin, suggesting that polyubiquitination of beta-catenin is regulated by competition between Siah-1 and TBL1 during Wnt signaling.

Research Highlights

Research Highlights

Seroprevalence of Human Herpes Simplex, Hepatitis B and Epstein-Barr Viruses in Children with Acute Lymphoblastic Leukemia in Southern Iran

To investigate the seroprevalence of Herpes Simplex Viruses (HSV1 and HSV2), Ebstein-Barr Virus (EBV) and Hepatitis B Virus (HBV) in children with acute lymphoblastic leukemia (ALL) in southern Iran. 90 patients with ALL and 90 age-sex matched healthy participants were enrolled in this study. Antibodies (IgG) against HBsAg, HSV1, HSV2, EBV different antigens including Epstein-Barr nuclear antigen-1 (EBNA-1), viral capsid antigen (VCA) and early antigen (EA) were measured by enzyme-linked immunosorbent assay (ELISA). There were 54 (60%) male and 36 (40%) female in both study groups with mean age of 8.47 ± 3.61 and 8.61 ± 2.84 years in case and control group respectively (P = 0.812). The prevalence of antibodies against HBsAg (P = 0.002), HSV1 (P < 0.0001), VCA (P = 0.021) and EA (P < 0.0001) antigens of EBV were significantly higher in ALL patients. With the results of this study, we could not exclude a connection between these viral infections and later leukemogenesis in childhood ALL, although nor latent infection nor congenital infection cannot be excluded by this method.

Molecular Diagnostics and Therapy of Acute Myeloid Leukemia

In 2008, the World Health Organization published a revised and updated edition of the classification of lymphoid tissues tumors. Within the category of indolent B-cell lymphomas there appeared new definitions and diagnostic criteria for established diseases such as chronic lymphocytic leukemia and Waldenstom’s macroglobulinemia. New provisional entities were introduced such as splenic B-cell lymphoma/leukemia, unclassifiable, splenic diffuse red pulp small B-cell lymphoma and hairy cell leukemia - variant. Clinically different pediatric follicular lymphoma and pediatric nodal marginal zone lymphoma have been singled out. ”Early” lymphoid proliferations with still undetermined clinical significance have been described such as monoclonal B-cell lymphocytosis, follicular and mantle cell lymphoma in situ. Diversity of morphological, biological and clinical features of diffuse large B-cell lymphoma (DLBCL) has served as basis to division into variants, subgroups, subtypes and clinico-pathological entities. Morphological variants, molecular subgroups based on gene-expression profiling (germinal center B-cell like and activated B-cell like) and immunohistochemical subgroups of DLBCL were included into an entity called DLBCL, not otherwise specified. New distinct DLBCL subtypes based on topography were defined to include primary DLBCL of the CNS and primary cutaneous DLBCL, leg type. The importance the role of Ebstein-Barr virus (EBV), human herpesvirus 8 (HHV-8) and immunodeficiency status in DLBCL pathogenesis served as basis for introduction of new clinico-pathological entities such as EBV positive DLBCL of the elderly, DLBCL associated with chronic inflammation and large B-cell lymphoma arising in HHV8-associated multicentric Castleman disease. Two new large B-cell lymphomas with features of DLBCL overlap with Burkitt lymphoma or classical Hodgkin lymphoma have been introduced.

Human herpes viral central nervous system infection in human immunodeficiency virus (HIV) and non-HIV patients: An 18-month prospective study

Human herpes virus (HHV) infection of the central nervous system (CNS) is a common problem worldwide. The incidence of HHV-CNS infection in human immunodeficiency virus/ acquired immunodeficiency syndrome (HIV/AIDS) patients and non-HIV patients has been studied at Rajavithi Hospital, Bangkok, Thailand. To identify the prevalence and incidence of HHV1 (HSV), HHV3 (VZV), HHV4 (EBV), HHV5 (CMV), HHV6A,B, and HHV 7-CNS infection, and to differentiate the clinical manifestations, laboratory findings between HSV-encephalitis and non-HSV/HHV-CNS infection amongst patients at Rajavithi Hospital, Bangkok, Thailand. An 18-month prospective study of patients with clinically suspected CNS infection was enrolled. Cerebrospinal fluid (CSF) examination and culture, along with real time polymerase chain reaction (RT-PCR) for HSV-1, HHV3, HHV4, HHV5, HHV6, HHV7 and Mycobacteriumtuberculosis were performed. Criteria for diagnosis of HHV-CNS infection included fever, headache, seizure, alteration of consciousness, neurological localizing signs and/or neck stiffness. A total of 94 patients, 52 male and 42 female, aged between 16 - 77 years (mean + SD = 42.3 + 14.5) were enrolled between July 2008 - December 2009. Forty four patients were confirmed to be HIV/AIDS positive. Of this, 27% were treated with highly active antiretroviral treatment (HAART). There was significant difference of age and gender between the HIV/AIDS subgroup versus the non-HIV subgroup (p < 0.026). The incidence of HHV encephalitis was 11.3% per-year. The incidence of HHV1 (HSV) viral encephalitis, HHV5 (CMV) latent infection, and HHV4 (EBV) encephalitis accounted for 5.67, 4.2 and 0.6% per year, respectively. There were no HHV6A, B, HHV7- CNS infections observed. The incidence of HHV encephalitis was noticeably higher in HIV/AIDS patients (p = 0.002). The CSF /blood sugar ratio observed in HSV1 encephalitis was higher than in non HSV/HHV-CNS infected patients (p = 0.06). Human herpes virus, especially HSV-CNS infection was found to be common in both HIV/AIDS and non HIV patients. The incidence of VZV, EBV, HHV6 and HHV7-CNS infection were rare. Unlike the CSF/blood sugar ratio and CSF pleocytosis, clinical manifestations may not be helpful for differentiation between HSV encephalitis and non HSV/HHV-CNS infection. Key words: Human herpes virus (HHV), central nervous system (CNS) infection, human immunodeficiency virus (HIV), viral encephalitis, herpes simplex virus (HSV), varicella zoster virus (VZV), ebstein - barr virus (EBV).

Viral Hepatitis in Solid Organ Transplant Recipients

Hepatotropic viral infections are frequent in allograft recipients and may be caused by a number of different viruses. Of these, the most important infectious agents are hepatitis B virus (HBV) and hepatitis C virus (HCV), which can cause both acute and chronic hepatitis. In addition, Hepatitis E virus (HEV), thought previously to only cause acute hepatitis in the developing world, is emerging as an increasing cause of chronic hepatitis and even cirrhosis in solid organ transplant recipients in industrialized countries(Gerolami, Moal et al. 2008; Kamar, Mansuy et al. 2008; Gerolami, Moal et al. 2009; Haagsma, Niesters et al. 2009). Hepatitis D virus (HDV) additionally plays an important role in both coinfection and superinfection of HBV in solid organ transplant recipients. In addition to the primary viral hepatitis infections, a variety of other systemic viral infections, such as the herpesviruses, cytomegalovirus (CMV), Ebstein Barr Virus (EBV), and varicella zoster virus (VZV) can have toxic effects on the liver in the posttransplant recipient. This chapter will focus primarily on the epidemiology, transmission, clinical presentation and management of the primary hepatitis viruses: HBV, HCV, HDV and HEV, following solid organ transplantation. General concepts in the prevention of post-transplant hepatotropic infections and recent advances and challenges will also be discussed.

Utility of Chimerism Analysis to Determine Tissue of Origin in Post Transplant Lymphoproliferative Disorder (PTLD).

Abstract 4305Post-transplant lymphoproliferative disorder (PTLD) is one of the major complications of organ transplantation. Most PTLDs are associated with Epstein-Barr virus (EBV) infection of B-lineage lymphocytes. Central nervous system (CNS) involvement is rare. Although most PTLDs following solid organ transplants is of recipient origin, PTLDs following bone marrow or stem cell transplant are mostly of donor cell origin. Origin of the tumor cells are of crucial importance in deciding treatment and predicting prognosis. Here we report a case of PTLD of diffuse large B cell Lymphoma of donor tissue origin determined by chimerism analysis. The patient was a 52-year-old woman with myelofibrosis (Myeloproliferative disorder) who received unrelated donor peripheral blood stem cell transplantation. The donor was an ABO compatible, HLA matched unrelated donor. Post transplant immunosuppression therapy was administered. The post transplant history was complicated by multiple viral infections, including BK, CMV and EB virus. Four months after transplantation, the patient developed fever and mental status changes, MRI of brain showed multiple enhancing lesions. Brain biopsy revealed brain tissue with dense infiltration of large atypical lymphoid cells predominantly perivascular in location. Immunohistochemical stains reveal that the large atypical lymphoid cells are of B-cell origin and these cells are 100% positive for Ebstein Barr virus by EBV encoded RNA by in-situ hybridization. The flowcytometry study revealed a monoclonal population of B cells with Kappa light chain restriction. These findings support the diagnosis of post transplant lymphoproliferative disorder (PTLD) of diffuse large B-cell lymphoma type. To determine the origin of tumor cells, chimerism analysis of the host DNA (buccal) and tumor DNA were performed. Short tandem repeat (STR) multiplex PCR assay were performed using the AmpFlSTR Identifiler PCR amplification kit (Applied Biosystems, Foster City, CA). After amplification, samples were analyzed on an ABI 310 DNA Sequencer (Applied Biosystems). The allele distribution was significantly different between the recipient DNA (from buccal swab) compared to tumor DNA indicating donor origin of the tumor (PTLD). The patient was then placed on high dose methotrexate and dexamethasome, however her condition deteriorated dramatically and the patient expired shortly following the diagnosis. It is known that the major pathogenetic defect of PTLD is the insufficient EBV-specific cytotoxic T-cell control of EBV-driven B-cell proliferations. Despite this understanding, determining the right therapy for any given patient with PTLD remains a major clinical issue. It is important to identify patients who will benefit from reduction of immunosuppression, who will benefit from Rituximab. It is also important to develop more effective, less toxic chemotherapies for resistant or aggressive disease. The chimerism analysis performed on our patient to identify tumor cell origin is an unique and reliable method to help directing clinical management of PTLD. Disclosures:No relevant conflicts of interest to declare.

Traveller’s headache

A 32-year-old, left-handed African woman presented with a 5 day history of increasingly severe headache, which was constant and worse on lying flat. During this period she also developed neck...

PI-10 The evaluation of serological profiles and the seroprevalence of Ebstein Barr virus among various age groups at Izmir Tepecik Educational and Research Hospital, Turkey: preliminary results

PI-10 The evaluation of serological profiles and the seroprevalence of Ebstein Barr virus among various age groups at Izmir Tepecik Educational and Research Hospital, Turkey: preliminary results

Lost central venous line caused tricuspid stenosis after 28 years

Sirs, A 45-year-old woman was referred for investigation because of dyspnoe on exertion. She had a history of Ebstein-Barr virus infection 28 years earlier. At that time she received oral analgetics for her sore throat with subsequent development of an anaphylactic shock. For the treatment of anaphylaxia she received a central venous line via the right subclavian vein. The patient fully recovered and was discharged after several days. Three years later a remaining central venous catheter ranging from the subclavian vein to the right ventricle was noted by X-ray examination. Since the patient was free of symptoms the catheter was left in place. The next 25 years were uneventful. Now echocardiography revealed signs of beginning right heart failure with dilation of the vena cava and the hepatic veins. MR imaging revealed interaction of the anterior tricuspid leaflet with the distal part of the central catheter (Fig. 1). Right heart catheterization showed calcification adherent to the catheter (Fig. 3). Simultaneous recording of right atrial and ventricular pressures demonstrated tricuspid stenosis with a mean pressure gradient of 5 mmHg (Fig. 2). Since MRI demonstrated adhesion of the proximal part of the catheter with the subclavian vein and adhesion of the distal part with the tricuspid valve no interventional approach to rescue the catheter was performed. The patient was transferred to the cardiac surgeons. The central line was removed surgically (Fig. 4). Intraoperatively Fig. 1 Cardiac MRI demonstrating the location of the catheter across the tricuspid valve. White arrows indicate catheter

Epidemiological features of Turkish patients with sarcoidosis

Epidemiological characteristics of sarcoidosis differ according to geographical distribution. The aim of our study was to disclose epidemiological characteristics in our country. The data was collected from investigators, who sent information on newly-diagnosed patients via internet. In 2 years 198 female and 95 male patients were enrolled to the study (f/m:2.08). Mean age of patients was 44+/-13 years (17-90). Mean age of male patients was 38+/-12 while mean age of female patients was 48+/-13 (p<0.001). 73.4% of patients were nonsmokers (85.4% of females; 48.4% of males; (p<0.001)). About 50% of our 293 patients were housewives. Familial sarcoidosis was found in 3 patients' first degree relatives. Estimated annual incidence of sarcoidosis for Turkey was calculated as 4 per 100,000 person. According to our study, 2/3 of sarcoidosis patients were women; mean age of patients was 45 and the disease began 10 years later in female patients. 80% of patients were nonsmokers; negative relation between sarcoidosis and smoking was evident especially in women. Familial sarcoidosis frequency was lower compared to other studies in the literature. There was no occupational exposure history in our patients. Our incidence rate, is similar with the results of other European studies.

Epstein-Barr virus-transformation of B-cell lines in ovarian cancer patients: feasibility of genomic storage for unlimited use

The aim of the current study is to test whether immortalized B-lymphocyte cell line via Ebstein-Barr virus (EBV) transformation is feasible and can be an unlimited source of genome wide study. We obtained peripheral whole blood from 5 ovarian cancer patients and immortalized the B-cell lines using EBV transformation. The success rate was analyzed and the bio-identity of the genome was performed using human leukocyte antigen (HLA) identity test. EBV transformation was successful in all 5 cases (95% confidence interval, 46.3% to 100%). After cryopreservation of EBV-transformed B-cell lines and subsequent thawing, we observed that all cell lines were viable and proliferative. To check bio-identity, HLA-A, B, and DR were tested between the genome of the original samples and the transformed samples. The HLA typing revealed that all observed HLA-A, B, and DR type was identical in 5 cases before and after EBV-transformation. The current results suggest that EBV-transformation of peripheral blood is an efficient tool in genome banking. The EBV-transformed B-cell lines may be a valuable resource of genome in multi-center translational research by the Korean Gynecologic Oncology Group.

Lymphoepitherial Carcinoma of the Parotid Gland; A Clinical Report of Three Cases

Lymphoepithelial carcinoma is a rare but unique malignancy of the major salivary glands. The incidence of lymphoepithelial carcinoma is 0.4-1.4% of the major salivary malignant neoplasms. According to several serologic, immunohistochemical, and in situ hybridization studies, lymphoepithelial carcinoma is strongly associated with Ebstein-Barr virus infection. We present three cases of lymphoepithelial carcinoma associated Ebstein-Barr virus in the parotid gland, which was first presented with a painless and gradually enlarging infraauricular mass. We reoport on the clinical investigation, cytologic, histopathologic features and proper management. Along with a review of literature. Korean J Otorhinolaryngol-Head Neck Surg 2009;52:604-7 Key WordsZZParotid gland·Lymphoepithelial carcinoma.

Hiv-Associated Lymphoma

A 39-year-old man with AIDS experienced worsening shortness of breath, cytopenia, and fever and was admitted to Baylor University Medical Center. The patient also reported symptoms of anorexia, diarrhea, abdominal pain, and generalized body pain. The physical examination showed cachexia; a large perineal Kaposi sarcoma tumor, as well as scattered Kaposi sarcoma lesions on his face, neck, back, and chest; dependent edema in the legs and scrotum; a scrotal ulcer; and abdominal distension with ascites and tenderness. No lymphadenopathy or hepatosplenomegaly was noted. A lung infiltrate and right-sided pleural effusion were evident, and the possibility of parapneumonic effusion was considered. A complete blood count demonstrated leukopenia (white blood cell count, 500 K/uL), anemia (hemoglobin, 8.6 g/dL), and thrombocytopenia (platelet count, 19,000 K/uL), with a virtual absence of CD4+ cells (<1%). The absolute lymphocyte count was 288 cells/L. HIV-1 RNA quantification by polymerase chain reaction was <50. The patient's blood cultures were also positive for Streptococcus viridans. The source of the infection was believed to be the skin, in association with Kaposi sarcoma. The patient was treated with broad-spectrum antibiotics, and follow-up blood cultures showed resolution of the infection. The pleural effusion was drained and sent for cytologic evaluation. Results showed highly atypical, pleomorphic lymphoid cells (Figures ​(Figures11 and ​and22). Usual B and T cell markers (CD3, CD5, CD10, CD15, CD20, CD79a, PAX5) were negative, and activation markers (CD30 and MUM1) were positive in this tumor. CD138 showed a minimal to no staining pattern (although most PELs show a positive reaction). The tumor proliferation marker MIB-1 (Ki-67) showed strong positivity, with staining of 75% of cells (Figure ​(Figure33). The cells were positive for human herpesvirus 8 (HHV8) and Epstein-Barr virus (EBV) (Figure ​(Figure44). The EBV copy number in the pleural fluid was 105,000/mL. Figure 1 (a) Highly cellular smear with multiple aggregates of mononuclear cells (×10, hematoxylin and eosin stain [H&E]). (b) Note the pleomorphic nature of the cells (×20, H&E). (c) Some of the cells show plasma cytoid features ... Figure 2 High-power view (×40, H&E) of primary effusion lymphoma. Note the multinucleated tumor cell with prominent macronucleoli (arrow) in a background of highly atypical pleomorphic mononuclear cells. Figure 3 Immunohistochemistry results showed positive staining (×10) for (a) CD30, (b) MUM1, and (c) MIB1 (75%). Figure 4 (a) Primary effusion lymphoma with a distinct, strong positive reaction to HHV8 (×10). (b) Ebstein-Barr virus–encoded small RNAs (EBER) staining showed scattered, slightly positive cells (×10). Although the differential diagnosis based on the clinical findings would include pyothorax-associated lymphoma, Burkitt lymphoma, lymphomatous effusion of disseminated lymphoma, malignant melanoma, and pleomorphic non–small cell carcinoma, the absence of HHV8 in each of these lymphomas eliminated them from consideration. Primary effusion lymphoma (PEL) was diagnosed.

Infective splenic rupture presenting with symptoms of a pulmonary embolism

Splenic rupture following infectious mononucleosis is rare. The case history is presented of a man who presented with sudden onset pleuritic left chest pain. An ultrasound scan of the abdomen...

Guillain–Barrè syndrome as a neurological complication of infective endocarditis. Is it really so rare and how often do we recognise it?

Guillain–Barrè syndrome (GBS) is an acute, inflammatory, demyelinating polyneuropathy that nowadays represents the most common cause of flaccid paralysis. GBS is considered a reactive, autoimmune disease preceded by a triggering event, such as a respiratory infection or gastroenteritis. Campylobacter jejuni, Mycoplasma pneumoniae, Cytomegalovirus and Ebstein Barr Virus are the most frequent antecedent pathogens isolated in GBS; nevertheless recent reports suggest that pathogens related to infective endocarditis may be the triggers of this generalized polyneuropathy. We discuss the likely pathogenesis of this rare association and review the pertinent literature.

Infusions of HSV-TK Engineered Donor Lymphocytes Effectively Protect Patients Undergoing Haploidentical Stem Cells Trasplantation (HSCT) from Infectious Mortality.

T-cell depletion (TCD) of allogeneic stem cells transplantation (HSCT) is the most powerful approach to overcome HLA barriers in patients with high risk malignancies, lacking a conventional donor. However, the prolonged immune deficiency resulting from TCD significantly impairs the outcome of HSCT from a haploidentical family donor (haplo-HSCT). In a phase I-II clinical trial (protocol MMTK007), we showed that the add-back of suicide-gene transduced donor lymphocytes (TK+ cells) provides early immune-reconstitution (IR), crucial to avoid opportunistic infections and disease relapse. While the achievement of an early and sustained IR significantly reduced the incidence of infectious complications and mortality, the kinetic of abatement of viral reactivations differed in different patients, suggesting variability in the repertoire, function and persistence of viral-specific T cells. To gain insights on the activity of the post-transplant immune system, we focused on immune responses to cytomegalovirus (CMV) and Ebstein Barr virus (EBV) as clinical paradigm of an effective immune system. In our trial 29 patients (median age 52y) were transplanted for high-risk leukemia. Seventeen pts received TK-DLI starting at day +42, 14 pts obtained prompt immune reconstitution with CD3+ >100/mcl at day +86 (median) from SCT and day +21 from TK-DLI. Twelve/14 experienced CMV reactivation, 3 reactivation/patient (median), each reactivation required 14 days (median) of pre-emptive treatment with foscarnet to achieve a complete clearance; in 2/38 events, a CMV antigenemia persistent during foscarnet treatment was cleared by ganciclovir administration. In this series, the last CMV reactivation requiring pre-emptive treatment happened at day +84 from SCT and day +19 from TK-DLI. Nine/14 experienced EBV reactivation, 1 reactivation/patient (median), 6 patients required treatment with rituximab (375 mg/mq weekly) for 3 cycles (median). In 3 cases we documented EBV lymphoproliferative disease, that were completely controlled with the treatment. The proportion of lymphocytes committed to produce IFN-γ upon CMV or EBV stimulation normalized within the first 3 months post transplant. The analysis of CMV and EBV T-cell response showed a prevalent host-restriction pattern, suggesting active modulation of the T-cell repertoire by the host environment. The TCR-Vβ repertoire progressively changed from oligoclonal into polyclonal and normalized by 1 year after transplant. The progressive acquirement of a protective, host-restricted, anti-viral response, highly correlated with a decline in the occurrence of any infectious event, that were nearly abrogated by 6th month post transplant. The overall cumulative infectious mortality beyond day +100 post transplant was 12,5% in TK treated patients demonstrating the efficacy of this strategy in building a protective immune system.

Juvenile Rheumatoid Arthritis in Children with Ebstein barr virus Infection

Juvenile Rheumatoid Arthritis (JRA) is a disease of unknown etiology. A total of 50 patients with JRA who were hospitalized in the Pediatrics Rheumatology Ward of Imam Khomeini Hospital in Tehran during the years 2001-2002, were assessed serologically (IgM and IgG specific viral capsid antigens) for EBV infection and their response to therapy was studied. Minimum age of the patients was at least 6 months and mean age was 60.96 plus/minus 43.46 months. EBV infection was seen in 44 (88%) patients 24 of whom were girls and 20 boys. Ninety two percent of girls and 83% boys were infected with the virus. Ebstein barr virus (EBV) infection was seen in 33 cases, 6 cases, 4 cases and 1 case in the polyarticular, pauciarticular, systemic and spondylitis group, respectively. Fifty four percent of EBV-positive patients with JRA did not respond to the classic therapy. EBV virus is involved in the pathogenesis of JRA and patients with EBV are in greater risk of developing JRA.

SDRA par pneumonie à EBV

RésuméIntroductionChez l’adulte immunocompétent, l’Epstein Barr (EBV) entraîne une maladie autolimitée spontanément résolutive.ObservationUn syndrome de détresse respiratoire aigu (SDRA) compliquant une pneumonie grave à EBV est rapporté avec le recours à une ventilation artificielle prolongée. Le diagnostic était confirmé par l’usage des sérologies spécifiques et la recherche de la charge d’ADN virale par PCR. À part la stratégie protectrice de la ventilation mécanique, le traitement médical a compris l’utilisation de l’Acyclovir et les immunoglobulines polyclonales dans la phase précoce ainsi que des corticoïdes systémiques dans la phase tardive. La guérison était progressive et complète.ConclusionLa pneumonie à EBV compliquée d’un SDRA chez les immunocompétents existe. Sa prise en charge est un défi diagnostique et thérapeutique.

Hepatitis C virus related lymphoproliferative disorder in a renal transplant recipient

Posttransplant lymphoproliferative disorders (PTLD) are commonly caused by Ebstein-Barr Virus infection. The role of hepatitis C virus (HCV) in the genesis of lymphomas has been recognized recently. We report a HCV infected renal transplant recipient who developed PTLD 11 months after transplantation. Reduction of immunosuppression led to disappearance of viremia and clearance of PTLD. This is the first such report in the world literature.