Human leukocyte antigen-A genotype as a predictor of cytomegalovirus-pp65 antigenemia and cytomegalovirus disease in solid-organ transplant recipients

Abstract

Background: Cytomegalovirus (CMV) infection is one of the most common and severe infections during the post-transplantation period. It threatens the survival of patients and the function of the transplanted organ.
Aim of the study: To screen for CMV infection among solid organ transplantation patients using monitoring of CMV phosphoprotein 65 (CMVpp65) antigenemia and to detect if CMV infection and disease were associated with certain human leukocyte antigen (HLA)-A locus genotypes among the studied group.
Subjects and methods: Thirty solid organ transplantation patients were included for posttransplantation follow up for symptoms and signs suggestive of CMV disease upto one year. Regular screening for CMV infection was done through CMVpp65 antigenemia detection by the immunofluorescence technique. In addition, HLA-A genotype was determined for all patients using the line probe assay.
Results: The present study showed that 9 out of 30 patients (30%) were positive for CMVpp65 antigenemia. The detected HLA-A alleles were HLA-A*01(no. = 16), HLA-A*02(no. =11), HLA-A*11(no. = 5), HLA-A*19(no. =1), HLA-A*24(no. = 4), HLA-A*29(no. = 1), HLA-A*30(no. = 16), HLA-A*92(no. = 4). Among the studied cases, 40% showed HLA-A* 01–30 type. There was a significant difference (P = 0.05) among detected HLA types as regards CMVpp65 antigenemia, with HLA-A*02_11 representing 33.3% of CMVpp65 positive patients and HLA-A*01_30 representing 57.1% of CMVpp65 negative patients. 
Conclusion: Certain HLA alleles may have either a protective or predisposing role in CMV reactivation. Thus, HLA typing might be helpful in estimating the risk of CMV disease during the posttransplantation period and designing individualized therapy as regards the choice between preemptive and prophylactic CMV therapy.