Viral Infections in Renal Transplant Recipients in Belarus

The presented study had its aim in establishing the prevalence and etiological structure of post-transplant viral complications and the kinetics of infection development. Two groups of recipients were examined: Group 1 comprised patients without any clinical signs of infection (n=84) monitored for a year, Group 2 included recipients with a clinical presentation of infection (n=92). 591 blood samples and 446 urine samples from 196 patients (20 donors and 176 renal transplant recipients) were analyzed. All donor-recipient pairs were tested for CMV, EBV, and HSV-1, 2. Latent viral infection reactivation was detected by the presence of viraemia (DNAemia) induced by CMV, EBV, HSV-1, 2, HHV-6, VZV, PVB19, or viruria (DNAuria) induced by BKV. The percentage of Group 1 patients with viral DNA detected amounted to 41.9% for CMV, 30.4% for EBV, 17.4% for BKV, 5.6% for HHV-6, 1.9% for AdV, and 1.7% for PVB19. HSV-1, 2 and VZV infections in this group were not observed. The rate of CMV, EBV, and BKV infection reactivation, determined by the viraemic patients percentage, increased with time and peaked 1, 1.5 and 2 months after transplantation for EBV, BKV, and CMV, respectively. Three to six months after transplantation, the percentage of patients with active CMV, EBV, or BKV infection decreased significantly; and later on, viraemia was only occasional finding in Group 1 patients. Examination of Group 2 patients revealed that the predominant etiological agents of post-transplant viral complications were CMV (24.4%), EBV (18.8%), and BKV (17.6%). The current study is the first complex investigation into the etiological structure and activation kinetics of viral infections in renal transplant recipients in Belarus. The results have major implications for early prevention of potential viral complications and adjustment of the therapy regimens for kidney transplant recipients currently in use.