Molecular epidemiology of Epstein-Barr virus in adult kidney transplant recipients

In transplant recipients, Epstein-Barr virus (EBV) infection may be related to posttransplantation lymphoproliferative disorders (PTLD), the most important risk factors for which are the patient's serostatus before transplantation and the level of immunosuppression. Herein, we have evaluated the impact of EBV in adult kidney transplant recipients by prospectively investigating its molecular epidemiology in 855 consecutive whole blood samples obtained from 290 patients. EBV-DNA monitoring by real-time polymerase chain reaction (PCR) was performed at 3-month intervals in the first year after transplantation and subsequently once a year. Moreover, we studied 55 healthy, non-transplant recipient, blood donors. PCR for EBV-DNA results were positive in 99/855 samples (11.6%) obtained from 72/290 patients (24.8%) versus none from healthy control subjects (P < .05). There were no differences in the prevalence of EBV-DNA positivity regarding demographic characteristics, underlying pathology leading to transplantation, renal function, and immunosuppressive protocol. Only 4 patients showed a viral load of >2,000 genome equivalents/mL whole blood at >12 months; no patient developed PTLD. In conclusion, although the occurrence of EBV-DNA positivity was frequent, it was usually at low levels of viral load, confirming that adult kidney graft recipients are at a low risk of developing PTLD.