Last Updated: 2009-11-09 17:01:31 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Infection with multiple cytomegalovirus (CMV) strains harboring different glycoprotein B (gB) polymorphisms may increase time to clearance in solid-organ transplant recipients.
"Transplant patients who develop CMV disease very commonly have simultaneous infection with different strains of the virus," senior investigator Dr. Atul Humar told Reuters Health. "Clearance of 'mixed infection' may be more difficult and is an important area for further study."
Dr. Humar of the University of Alberta, Edmonton and colleagues came to this conclusion after conducting gB genotyping in 239 solid organ transplant recipients at the start of antiviral therapy.
Distribution was 26% for gB1, 10% for gB2, 10% for gB3, and 5% for gB4. Altogether, 49% of the patients had mixed infection.
Median baseline viral loads were significantly higher and time to viral eradication was significantly longer for mixed infection.
Further analysis showed that after adjustment, mixed infection was a significant predictor of failure to eradicate the virus by day 21 (odds ratio, 2.66). However, gB genotype had no influence on virologic or clinical CMV recurrence.
"Although no specific gB genotype appears to confer a specific viral virulence advantage," the investigators conclude, "mixed infection was associated with higher viral loads and delayed virologic clearance, suggesting a potential role for viral polymorphisms in influencing in vivo viral fitness."
Clin Infect Dis 2009;49:1160-1166.
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