Frequency of herpes virus infections activation in renal graft recipients

Abstract

Immunosuppressive treatment during the first year after renal transplantation leads to viral infection development in recipients, and graft dysfunction up to its loss. This original article gives data on comparison of T-lymphocytes subsets in healthy blood donors and renal graft recipients before and one month after transplantation. The influence of T-cell immunity impairment on CMV- and EBV-infection emergence were evaluated. 19 renal graft recipients were included in the study (average age — 43, m/f ratio — 14/5). 20 healthy blood donors were used as controls. A month after transplantation during induction (Methylprednisolone and Basiliximab) and basis (Prednisolone, Tacrolimus, Mycophenolate mofetil) therapy 10 (53%) patients had makers of CMV replication and 7 (36.9%) patients had markers of EBV replication. The majority of CMV- and EBV-positive patients proved reactivation of endogenous CMV and EBV (not primary infection). All patients, subsequently positive for CMV and EBV, demonstrated T-cells subpopulations discount before transplantation, such as a decrease in the total number of lymphocytes and absolute number of naïve CD4+ and СD8+ cells, effector memory CD4+ cells, T-regulatory cells (CD4+/CD25+/CD127–) in comparison to the control group. EBV-positive patients also showed the reduction of CD3+, absolute number of CD4+ and CD8+, but central memory CD8+ cells increased in comparison to the control group. Viral reactivation rate during first month after renal transplantation depends not only on immunosuppressive regimen but on T-cells subsets disproportions before graft. These indicators could be taken into account for viral infection expectancy.