Monitoramento da infecção por citomegalovírus em pacientes submetidos a transplante renal

Abstract

Cytomegalovirus infection is an important complication after renal transplantation. The use of immunosuppressants in the prevention of rejection may trigger changes in the behavior of CMV, it is important to post-transplant viral follow-up, as preventive measure, to limit clinical impact of this vírus. The objective of this study was to monitor cytomegalovirus infection in patients who underwent renal transplant in the Onofre Lopes University Hospital (HUOL), Natal, Rio Grande do Norte. In total were included 165 patients in the period from 2013 to 2016. Samples of peripheral blood obtained on the 2nd, 4th, 8th, 12th and 24th weeks post-transplant to molecular detection of CMV by nested-PCR and quantification of CMV viral load by real-time PCR. Who renal transplants presented incidence of 59.4% of active CMV infection was, correlation with the use of everolimus (p = 0.0008) and thymoglobulin (p = 0.0042). Forty-five patients who presented copy numbers above the cut-off point (4600 copies/mL), with sensitivity of 67.2% and specificity of 70.7%, associated were clinical signs and symptoms of CMV infection, such as fever, gastrointestinal disturbance, myalgia, leukopenia and thrombocytopenia. Our results demonstrated a high incidence of active CMV infection, evidencing the necessity of the early diagnosis of this infection, in addition to real-time PCR can be using to monitor CMV symptomatic infections in renal transplant recipients.