Clinical implications of quantitative real time-polymerase chain reaction of parvovirus B19 in kidney transplant recipients - a prospective study

Abstract

This prospective study was designed to investigate the clinically significant level of parvovirus B19 viral load using quantitative real‐time (RT) polymerase‐chain reaction (PCR) in kidney transplantation (KT) recipients. One hundred forty‐three adult recipients who underwent their first KT between November 2003 and October 2005 were enrolled. Six blood samples (the first taken preoperatively, subsequent samples taken every 4 weeks for 20 weeks) were taken from each patient for parvovirus B19 DNA RT‐PCR analysis. All recipients were diligently followed for 1 year post‐transplant. One hundred sixty‐eight of the 715 (23.5%) postoperative samples were positive for parvovirus B19 PCR. Eighty‐four of the 143 KT recipients (58.7%) showed at least one positive PCR. Sixteen of the 143 (11.1%) KT recipients had sustained severe anemia (SSA) with hemoglobin lower than 7.0 g/dl, after 4 weeks post‐transplant. The incidence of SSA in recipients with a titer higher than 1 × 10⁶ copies/5 μl whole blood was significantly higher than those with a negative or low titer (P < 0.001, positive predictive value 84.6%, negative predictive value 96.2%). In conclusion, a high titer of parvovirus B19 DNA higher than 1 × 10⁶ copies/5 μl whole blood in KT recipients was related with SSA after 4 weeks post‐transplant.