Dheerasekara Kalpa, Tharanga Rekshi, Rajamanthri Lakmali, Wazil Abdul, Nanayakkara Nishantha, Muthugala Rohitha
Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka.
Department of Virology, National Hospital Kandy, Sri Lanka.
Int J Health Sci (Qassim). 2023 Sep-Oct;17(5):39-44.
The prevalence and reactivating pattern of cytomegalovirus (CMV) among renal transplant recipients in Sri Lanka is scarce. The study was aimed to describe the replication patterns of CMV in post-renal transplant recipients who were on pre-emptive therapy and identify the risk factors and time period for CMV reactivating during the 1 year of transplantation and provide an insight into the selection of pre-emptive therapy in the local setting.
A retrospective and cohort study was conducted, enrolling renal transplant recipients who have completed routine 1-year follow-up for pre-emptive management at the National Hospital, Kandy, from January 2016 to January 2021. CMV quantitative polymerase chain reaction results and demographic data of enrolled recipients were analyzed to investigate the CMV replication pattern and risk factors. Categorical data were analyzed using Pearson's Chi-square test, considering < 0.05 statistically significant. Continuous variables were presented as percentages.
Two hundred and fifty-one renal transplant recipients' data were included in the study. Of them, 75.70% were male patients, and the mean age of the study population was 43.25 years. CMV DNAemia incidence was 56.57% during the 1 year of post-renal transplantation. Only 9.16% had developed more than 10 IU/mL or significant DNAemia. Sex and donor type were not risk factors for CMV reactivation. However, the recipient's age was significantly associated with CMV viraemia among renal transplant recipients.
Considering the low incidence of significant viraemia among the study population, pre-emptive treatment would be the cost-effective strategy for management of the post-renal transplant recipients in local settings.
斯里兰卡肾移植受者中巨细胞病毒（CMV）的流行情况和再激活模式尚不清楚。本研究旨在描述接受抢先治疗的肾移植术后受者中CMV的复制模式，确定移植后1年内CMV再激活的危险因素和时间段，并为当地环境中抢先治疗的选择提供见解。
进行了一项回顾性队列研究，纳入了2016年1月至2021年1月在康提国立医院完成常规1年抢先治疗随访的肾移植受者。分析纳入受者的CMV定量聚合酶链反应结果和人口统计学数据，以研究CMV复制模式和危险因素。分类数据采用Pearson卡方检验进行分析，P<0.05具有统计学意义。连续变量以百分比表示。
本研究纳入了251例肾移植受者的数据。其中，75.70%为男性患者，研究人群的平均年龄为43.25岁。肾移植术后1年内CMV血症发生率为56.57%。只有9.16%的患者出现了超过10 IU/mL的CMV血症或显著的病毒血症。性别和供体类型不是CMV再激活的危险因素。然而，受者年龄与肾移植受者的CMV病毒血症显著相关。
考虑到研究人群中显著病毒血症的发生率较低，抢先治疗将是当地肾移植术后受者管理的具有成本效益的策略。
