بررسی شیوع عفونت ویروس اپشتین بار(EBV) و عوامل مرتبط در بیماران دریافت کننده پیوند کلیه در بیمارستان امام خمینی ارومیه در فاصله سالهای 83-1381

Introduction: EBV is categorized as Herpesviridans and by nature is a Lymph crypto Virus. Studies have demonstrated that EBV will infect 80 to 90 percent of patients during the first year and there is a close relation between kidney malfunction and EBV infection. Reactivation of the virus excites the immune system, and ultimately leads to rejection of kidney. The purpose of this study was to determine the prevalence and identify the affecting factors of EBV infection among renal allograft recipients. Methods: This descriptive study was conducted on 68 renal allograft recipients hospitalized in Imam Khomeini medical center from 2001 to 2004. Blood sample was taken from subjects before kidney transplantation and it was being taken every 3 months during the first year after transplantation. Elisa Serologic tests were implemented to determine the antibody virus EBV antigens, such as VCAIgM, VCAIgG and EBNAIgG. Information about patients was obtained from their medical records and necessary forms were filled. Types of prescribed immunosuppressive agents and the status of kidney rejection was closely observed to identify the factors affecting rejection. Results: This study showed that EBV infection was previously developed in 85.3 %of subjects (58 patients) and Active Infection was found in14.7 % of subjects (10 patients). EBV Seronegativity and Primary infection was not found in this sturdy. Active infection and secondary EBV was detected in 58.8% of subjects (40 patients) during the first year after transplantation. 95.6 % (65 of recipients) before transplantation were seropositive for EBNAIgG and after transplantation, 100% (All of them) were positive. 92.6 % (63 of recipients) before transplantation were seropositive forVCAIgG and after transplantation, 96.9% (66 of them) were positive. 95.6% of recipients (65 of them) were seropositive for EBNAIgG before transplantation, while after transplantation the rate was 100% (all of the recipients). Active and secondary infection was detected in 65.8% of recipients (23 patients) receiving Cyclosporine, Prednisolone and Azatioprine and in 33.3 %of patients receiving Cyclosporine, Prednisolone and MMF and in 57.9 %of patients receivingCyclosporine and Prednisolone. During the first year after transplantation 19 of patients developed an acute rejection of which 6 (31.5%) had history of previous infection and the rest 13 (68.5%) were infected by active virus. On comparison of this group with those who did not develop acute rejection, there was no statistical significant relation between type of infection and the rate of the acute rejection. Although reactivated EBV was detected in 53.9 % of recipients (14 of them) who were treated by ALG, there was no statistical significant difference from those 27 recipients who did not get ALG. Conclusion: Just like other countries, this study indicates the activity pattern, in which this virus develops from hidden to active and then secondary during the time axis after transplantation. To determine the cause of reactivation of virus and secondary EBV, all related affecting factors such as ALG, acute rejection and immunosuppressive drugs were studied, but none of them played an effective role in reactivation of the virus