Epstein-Barr Virus Infection in Renal Transplant Recipients

Effects of Antithymocyte Globulin and Interferon

  1. SARAH H. CHEESEMAN, M.D.;
  2. WERNER HENLE, M.D.;
  3. ROBERT H. RUBIN, M.D.;
  4. NINA E. TOLKOFFRUBIN, M.D.;
  5. BENEDICT COSIMI, M.D.;
  6. KARI CANTELL, M.D.;
  7. SUSAN WINKLE, B.A.;
  8. JOHN T. HERRIN, M.B.B.S.;
  9. PAUL H. BLACK, M.D.;
  10. PAUL S. RUSSELL, M.D.; and
  11. MARTIN S. HIRSCH, M.D.
  1. Boston, Massachusetts; Philadelphia, Pennsylvania; and Helsinki
    , Finland

    Abstract

    We studied Epstein-Barr (EB) virus excretion and antibody in 41 renal transplant recipients enrolled in a placebocontrolled trial of human leukocyte interferon. Half the patients were also treated with antithymocyte globulin. Epstein-Barr virus excretion occurred more often in recipients of cadaver kidneys (P = 0.03) and those receiving antithymocyte globulin (P = 0.04) and less often in patients given interferon (P = 0.08). Antibody to viral capsid antigen increased fourfold or more in 12 of 22 patients treated with antithymocyte globulin and in none of the non-antithymocyte globulin-treated group (P = 0.0002). Antibody to the restricted component of early antigen rose fourfold or more in eight patients and appeared related to the occurrence of syndromes similar to those attributed to cytomegalovirus in transplant recipients. We conclude that increasing immunosuppression augments the rate of EB virus reactivation and that EB virus may be an important pathogen in heretofore ill-defined syndromes.

    Article and Author Information

    • ▸From the Department of Medicine and Surgery, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts; The Division of Virology, The Joseph Stokes, Jr., Research Institute, The Children's Hospital of Philadelphia and School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and the Central Public Health Laboratory, Helsinki, Finland.

    • Grant support: in part by research grants CA 12464 and CA 04568 and contracts 1-CP-43222 and NO1-33272 from the National Cancer Institute. Dr. Cheeseman was a recipient of National Research Service Award 1F32 CA05707. Dr. Henle is a recipient of Career Award 5-K6-AI22683 from the National Institutes of Health.

    • ▸Requests for reprints should be addressed to Martin S. Hirsch, M.D.; Infectious Disease Unit, Massachusetts General Hospital; Boston, MA 02114.

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    1. Ann Intern Med July 1, 1980 vol. 93 no. 1 Part 1 39-42
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