韩国首尔实体器官移植受者和供者的人巨细胞病毒血清流行率和滴度。
Human cytomegalovirus seroprevalence and titres in solid organ transplant recipients and transplant donors in Seoul, South Korea.
机构信息
Department of Internal Medicine, Division of Infectious Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
出版信息
BMC Infect Dis. 2019 Nov 8;19(1):948. doi: 10.1186/s12879-019-4607-x.
BACKGROUND
Human cytomegalovirus (HCMV) can cause poor outcomes in solid organ transplant (SOT) recipients; moreover, it is associated with cardiovascular diseases (CVD) in the general population. Accordingly, anti-HCMV immunoglobulin G (IgG) seroepidemiology may be useful in identifying the risk of post-SOT HCMV infection or disease as well as immunosenescence or CVD. However, HCMV seroprevalence and titre have not been fully evaluated with regard to age distribution or compared between SOT recipients and healthy individuals in South Korea.
METHODS
We retrospectively retrieved all unduplicated anti-HCMV IgG results of individuals aged > 1 year evaluated between July 2006 and November 2017 at Severance Hospital in Seoul. The cohort, excluding haematopoietic stem cell transplant recipients and subjects with equivocal values, included 2184 SOT recipients and 3015 healthy transplant donors. All IgG results in the SOT recipients were measured during the pre-transplant period.
RESULTS
The overall IgG seroprevalence and titres were significantly higher among SOT recipients than among healthy donors (98.7% vs. 88.6%, p < 0.001, and 64.7 ± 44.3 vs. 49.8 ± 20.6 arbitrary units/mL, p < 0.001, respectively). The lowest seropositive rate in the SOT group was observed in recipients aged between 11 and 15 years (70.6%). The frequency of seropositivity among adults aged ≥41 years increased to ≥90% in SOT recipients and healthy donors. Age was independently associated with higher HCMV seroprevalence (41-60 years, OR, 76.4, 95% CI, 24.5-238.9, p < 0.001; ≥ 61 years, OR, 4.4, 95% CI, 1.3-14.9, p < 0.001, compared to ≤40 years). The healthy donor group had an independently low HCMV seropositive rate (OR, 0.1, 95% CI, 0.1-0.2, p < 0.001).
CONCLUSIONS
HCMV seropositivity was the lowest among school-aged children and adolescents. IgG testing revealed an intermediate serostatus risk of post-transplant HCMV infection and disease for most adult SOT recipients in South Korea.
背景
人类巨细胞病毒（HCMV）可导致实体器官移植（SOT）受者预后不良；此外，它与普通人群的心血管疾病（CVD）有关。因此，抗 HCMV 免疫球蛋白 G（IgG）血清流行病学可用于识别 SOT 后 HCMV 感染或疾病以及免疫衰老或 CVD 的风险。然而，HCMV 血清流行率和滴度尚未根据年龄分布进行充分评估，也未在韩国的 SOT 受者和健康个体之间进行比较。
方法
我们回顾性检索了 2006 年 7 月至 2017 年 11 月期间在首尔塞弗伦斯医院接受年龄> 1 岁的个体的所有未重复的抗 HCMV IgG 结果。该队列排除了造血干细胞移植受者和具有可疑值的个体，包括 2184 名 SOT 受者和 3015 名健康的移植供体。SOT 受者的所有 IgG 结果均在移植前期间测量。
结果
与健康供体相比，SOT 受者的 IgG 血清阳性率和滴度均显著更高（98.7%比 88.6%，p < 0.001，64.7 ± 44.3 比 49.8 ± 20.6 个任意单位/mL，p < 0.001）。SOT 组中血清阳性率最低的是 11 至 15 岁的受者（70.6%）。≥41 岁的成年 SOT 受者和健康供体的血清阳性率频率增加至≥90%。年龄与更高的 HCMV 血清流行率独立相关（41-60 岁，OR，76.4，95%CI，24.5-238.9，p < 0.001；≥61 岁，OR，4.4，95%CI，1.3-14.9，p < 0.001，与≤40 岁相比）。健康供体组的 HCMV 血清阳性率独立较低（OR，0.1，95%CI，0.1-0.2，p < 0.001）。
结论
在校儿童和青少年的 HCMV 血清阳性率最低。在韩国，大多数成年 SOT 受者的 IgG 检测显示出移植后 HCMV 感染和疾病的中等血清学风险。
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