Single-Center Outcomes of Epstein–Barr Virus DNAemia in Adult Solid Organ Transplant Recipients
Table 1
Characteristics of solid organ transplant recipients according to development of EBV DNAemia.
Characteristics
Total (n = 442)
EBV DNAemia (n = 18)
No EBV DNAemia (n = 424)
value
Median age at transplant, years (IQR)
55 (23–74)
54.5 (50–68)
55 (24–74)
0.47
Male, sex, n (%)
314 (71.0)
10 (55.6)
304 (71.2)
0.14
Transplant organ, n (%)
0.59
Kidney
258 (58.4)
10 (55.6)
248 (58.5)
Liver
141 (31.9)
5 (27.8)
136 (32.1)
Pancreas
6 (1.4)
1 (5.6)
5 (1.2)
Kidney-liver
15 (3.4)
1 (5.6)
14 (3.3)
Kidney-pancreas
22 (5.0)
1 (5.6)
21 (5.0)
Previous transplant, n (%)
37 (8.4)
3 (16.7)
34 (8.0)
0.19
EBV serostatus at transplant, n (%)
<0.001
EBV low risk (D−/R−)
4 (1.0)
0
4 (1.0)
EBV intermediate risk (R+)
430 (97.3)
15 (83.3)
415 (97.9)
EBV high risk (D+/R−)
8 (1.8)
3 (16.7)
5 (1.2)
CMV serostatus at transplant, n (%)
0.74
CMV low risk (D−/R−)
107 (24.2)
3 (16.7)
104 (24.5)
CMV intermediate risk (R+)
239 (54.1)
11 (61.1)
228 (53.8)
CMV high risk (D+/R−)
96 (21.7)
4 (22.2)
92 (21.7)
Induction immunosuppression, n (%)
Basiliximab
37 (8.4)
2 (11.1)
35 (8.4)
0.67
Polyclonal antilymphocyte antibodies
279 (63.1)
11 (61.1)
268 (62.3)
0.86
Steroids†
127 (28.7)
5 (27.8)
122 (28.8)
0.93
Maintenance immunosuppression, n (%)
Cyclosporine
7 (1.6)
1 (5.6)
6 (1.4)
0.17
Tacrolimus
435 (98.4)
17 (94.4)
418 (98.6)
0.17
Azathioprine
1 (0.2)
0
1 (0.2)
0.84
Mycophenolate
436 (98.6)
18 (100)
418 (98.6)
0.61
Sirolimus
4 (0.9)
0
4 (0.94)
0.68
Belatacept
1 (0.2)
0
1 (0.2)
0.84
Prednisone <20 mg/day
30 (6.8)
2 (11.1)
28 (6.6)
0.46
Prednisone (≥20 mg/day)
6 (1.4)
0
6 (1.4)
0.61
Episode of rejection, n (%)
82 (18.6)
5 (27.8)
77 (18.2)
0.30
Clinical outcomes, n (%)
Development of PTLD
6 (1.4)
3 (16.7)
3 (0.7)
<0.001
Reduction in immunosuppression
6 (1.4)
3 (16.7)
3 (0.7)
<0.001
Receipt of anti-CD20 agent
6 (1.4)
3 (16.7)
3 (0.7)
<0.001
Receipt of chemotherapy‡
3 (0.1)
1 (5.6)
2 (0.1)
0.01
No development of PTLD
436 (98.6)
15 (83.3)
421 (99.3)
Reduction in immunosuppression
2 (0.4)
2 (11.1)
0
<0.001
Receipt of anti-CD20 agent
1 (0.2)
1 (5.6)
0
<0.001
Alive at 1 year
426 (96.4)
17 (94.4)
409 (96.4)
0.65
EBV, Epstein–Barr virus; CMV, cytomegalovirus; IQR, interquartile range. †≥1 g methylprednisolone or equivalent. ‡Chemotherapy regimens for these three patients included (1) etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (DA-EPOCH); (2) rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP); and (3) R-CHOP and later EPOCH with bortezomib.
