A review of herpesvirus infections in kidney transplant recipients: Diagnosis, treatment, and preventive strategies

Document Type : Analytic Review

Authors
M. Eslami Kojidi 1
A. Yarmohamadi 2
M. Gholami Barzoki 1
S. Shatizadeh Malekshahi 1
1 Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
2 Labbafinezhad hospital, Shahid Beheshti University of Medical Sciences
Abstract
Kidney transplantation is one of the best treatment methods for people with chronic kidney failure, and a large number of kidney transplants are performed worldwide every year. Pathogens that commonly infect kidney transplant recipients are viruses, bacteria, and protozoa. Among these, viruses are considered one of the biggest life-threatening factors in kidney transplant recipients. The reactivation of herpesviruses from the latent state often occurs in conditions of weakening the immune system, including after kidney transplantation. Infection with herpesviruses is still one of the main causes of complications and death for most kidney transplant recipients. Rapid diagnosis of active infection of these viruses in kidney transplant patients has a significant impact on the use of appropriate treatment strategies to reduce complications and transplant rejection. For this reason, this review aims to provide information about the preventive strategies, diagnosis, and treatment of herpesviruses infections in kidney transplant recipients. In this brief review, we have updated the information presented in previous articles and adjusted it based on recent advances, updated clinical guidelines, and common post-transplant tactics to minimize the risk of infection.

Keywords

Subjects

1. Jenkins FJ, Rowe DT, Rinaldo Jr CR. Herpesvirus infections in organ transplant recipients. Clin Vaccine Immunol. 2003;10(1):1-7.
2. Vanichanan J, Udomkarnjananun S, Avihingsanon Y, Jutivorakool K. Common viral infections in kidney transplant recipients. Kidney Res Clin Pract. 2018;37(4):323.
3. Ylinen E, Lehtinen S, Jahnukainen T, Karlsson T, Loginov R, Mannonen L, et al. Human herpes virus 6 infection in pediatric organ transplant patients. Pediatr Transplant. 2017;21(4):e12905.
4. Sehrawat S, Kumar D, Rouse BT. Herpesviruses: harmonious pathogens but relevant cofactors in other diseases? Front cell infect microbiol. 2018;8:177.
5. Malahe SRK, van Kampen JJ, Manintveld OC, Hoek RA, den Hoed CM, Baan CC, et al. Current perspectives on the management of herpesvirus infections in solid organ transplant recipients. Viruses. 2023;15(7):1595.
6. Abad CL, Razonable RR, editors. α Herpes virus infections among renal transplant recipients. Semin Nephrol; 2016;36:344-350.
7. Kho MML, Weimar W, Malahe SRK, Zuijderwijk JM, de Kuiper R, Boer-Verschragen MJ, et al. Boosting the VZV-Specific Memory B and T Cell Response to Prevent Herpes Zoster After Kidney Transplantation. Front Immunol. 2022;13:927734.
8. Pavlopoulou ID, Poulopoulou S, Melexopoulou C, Papazaharia I, Zavos G, Boletis IN. Incidence and risk factors of herpes zoster among adult renal transplant recipients receiving universal antiviral prophylaxis. BMC Infect Dis. 2015;15(1):285.
9. Ponticelli C. Herpes viruses and tumours in kidney transplant recipients. The role of immunosuppression. OPU. 2011. p. 1769-75.
10. Eslami Kojidi M, Shatizadeh Malekshahi S, Jabbari MR. Assessment of Human Cytomegalovirus Viral Load in Kidney Transplant Recipients in Tehran, Iran. Infect epidemiol microbiol. 2023;9(4):323-30.
11. Luan FL, Samaniego M, Kommareddi M, Park J, Ojo AO. Choice of induction regimens on the risk of cytomegalovirus infection in donor‐positive and recipient‐negative kidney transplant recipients. Transpl Infect Dis. 2010;12(6):473-9.
12. Schottstedt V, Blümel J, Burger R, Drosten C, Gröner A, Gürtler L, et al. Human cytomegalovirus (HCMV)–revised. Transfus med hemother. 2010;37(6):365.
13. Jutta KP, Daniel CB, Jay F, Upton A. Canadian society of transplantation consensus workshop on cytomegalovirus management in solid organ transplantation final report. Am J Transplant. 2005;5(2):218-27.
14. Barnes S, Schilizzi O, Audsley KM, Newnes HV, Foley B. Deciphering the immunological phenomenon of adaptive natural killer (NK) cells and cytomegalovirus (CMV). Int J Mol Sci. 2020;21(22):8864.
15. Pullerits K, Garland S, Rengarajan S, Guiver M, Chinnadurai R, Middleton RJ, et al. Kidney Transplant-Associated Viral Infection Rates and Outcomes in a Single-Centre Cohort. Viruses. 2022;14(11):2406.
16. Lazzarotto T, Spezzacatena P, Pradelli P, Abate DA, Varani S, Landini MP. Avidity of immunoglobulin G directed against human cytomegalovirus during primary and secondary infections in immunocompetent and immunocompromised subjects. Clin Diagn Lab Immunol. 1997;4(4):469-73.
17. Hebart H, Lengerke C, Ljungman P, Paya C, Klingebiel T, Loeffler J, et al. Prospective comparison of PCR-based vs late mRNA-based preemptive antiviral therapy for HCMV infection in patients after allo-SCT. Bone marrow transplant. 2011;46(3):408-15.
18. Santos CA, editor Cytomegalovirus and other β-herpesviruses. Semin Nephrol. 2016;36:351-361.
19. Agrawal A, Ison MG, Danziger-Isakov L. Long-term infectious complications of kidney transplantation. Clin J Am Soc Nephrol. 2022;17(2):286-95.
20. Eslami Kojidi M, Shatizadeh Malekshahi S, Jabbari MR. The simultaneous presence of active BK, Epstein Barr, and human cytomegalovirus infection and their correlation by host factors in patients suspected of kidney transplant rejection. BMC Infect Dis. 2024;24(1):937.
21. Chan K, Tam J, Peiris J, Seto W, Ng M. Epstein–Barr virus (EBV) infection in infancy. J Clin Virol. 2001;21(1):57-62.
22. Lautenschlager I, Razonable RR. Human herpesvirus-6 infections in kidney, liver, lung, and heart transplantation: review. Transpl Int. 2012;25(5):493-502.
23. Einollahi B. Kaposi sarcoma after kidney transplantation. Iran J Kidney Dis. 2007;1(1):2-11.
24. Iftode N, Rădulescu MA, Aramă ȘS, Aramă V. Update on Kaposi sarcoma-associated herpesvirus (KSHV or HHV8)–review. Rom J Intern Med. 2020;58(4):199-208.
Pathobiology Reserach
Volume 26, Issue 3
September 2023
Pages 43-49