CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant Recipients
Pneumocystis pneumonia (PcP) remains life-threatening in kidney transplant recipients (KTR). Our study investigated risk factors one-year before PcP. We conducted a monocentric, case-control study including all KTR at the Dijon University Hospital (France) with a diagnosis of PcP between 2005 and 20...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Transplant International |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.12192/full |
| _version_ | 1827292162438463488 |
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| author | Isabelle Eberl Christine Binquet Christine Binquet Adrien Guilloteau Mathieu Legendre Frederic Dalle Frederic Dalle Lionel Piroth Lionel Piroth Lionel Piroth Claire Tinel Claire Tinel Mathieu Blot Mathieu Blot Mathieu Blot Mathieu Blot |
| author_facet | Isabelle Eberl Christine Binquet Christine Binquet Adrien Guilloteau Mathieu Legendre Frederic Dalle Frederic Dalle Lionel Piroth Lionel Piroth Lionel Piroth Claire Tinel Claire Tinel Mathieu Blot Mathieu Blot Mathieu Blot Mathieu Blot |
| author_sort | Isabelle Eberl |
| collection | DOAJ |
| description | Pneumocystis pneumonia (PcP) remains life-threatening in kidney transplant recipients (KTR). Our study investigated risk factors one-year before PcP. We conducted a monocentric, case-control study including all KTR at the Dijon University Hospital (France) with a diagnosis of PcP between 2005 and 2022 (cases), and matched control KTR with no history of PcP (3 controls/case). Among all 1,135 KTR, 57 cases (5%) and 169 matched-controls were included. PcP was associated with 18% mortality. Compared to controls, cases were older, with a higher immunological risk, and CMV infection was more frequent in the year preceding the occurrence of PcP (23% vs. 4%; p < 0.001). As early as 1 year before PcP, lymphocyte counts were lower and serum creatinine levels were higher in cases, but immunosuppressive regimens were not significantly different. Multivariable analysis identified lymphocyte count, serum creatinine level, being treated by immunosuppressive therapy other than anti-rejection drugs, and CMV infection in the year preceding the time PcP as independently associated with the occurrence of PcP. PcP was associated with an increased risk of subsequent chronic rejection (27% vs. 3%; p = 0.001) and return to dialysis (20% vs. 3%; p = 0.002). The occurrence of CMV infection and a low lymphocyte count could redefine the indications for continuation or reinitiation of anti-Pneumocystis prophylaxis. |
| first_indexed | 2024-04-24T12:58:21Z |
| format | Article |
| id | doaj.art-1a12ca4657004a12b53ba6b3c06d8238 |
| institution | Directory Open Access Journal |
| issn | 1432-2277 |
| language | English |
| last_indexed | 2024-04-24T12:58:21Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Transplant International |
| spelling | doaj.art-1a12ca4657004a12b53ba6b3c06d82382024-04-05T16:29:09ZengFrontiers Media S.A.Transplant International1432-22772024-01-013710.3389/ti.2024.1219212192CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant RecipientsIsabelle Eberl0Christine Binquet1Christine Binquet2Adrien Guilloteau3Mathieu Legendre4Frederic Dalle5Frederic Dalle6Lionel Piroth7Lionel Piroth8Lionel Piroth9Claire Tinel10Claire Tinel11Mathieu Blot12Mathieu Blot13Mathieu Blot14Mathieu Blot15Department of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, FranceCHU Dijon-Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, FranceLabEx LipSTIC, University of Burgundy, Dijon, FranceCôte d´Or Haematological Malignancy Registry (RHEMCO), Dijon-Bourgogne University Hospital, Dijon, FranceDepartment Nephrology and Kidney Transplantation, Dijon-Bourgogne University Hospital, Dijon, FranceDepartment of Parasitology-Mycology, Dijon Bourgogne University Hospital, Dijon, FranceUMR PAM Université de Bourgogne Franche-Comté (UBFC), AgroSup Dijon, Équipe Vin, Aliment, Microbiologie, Stress, Groupe Interactions Candida-muqueuses, Dijon, FranceDepartment of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, FranceCHU Dijon-Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, FranceLabEx LipSTIC, University of Burgundy, Dijon, FranceDepartment Nephrology and Kidney Transplantation, Dijon-Bourgogne University Hospital, Dijon, FranceUniversité Bourgogne Franche-Comté (UBFC), EFS BFC, Inserm UMR1098, RIGHT, Besançon, FranceDepartment of Infectious Diseases, Dijon-Bourgogne University Hospital, Dijon, FranceCHU Dijon-Bourgogne, INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, FranceLabEx LipSTIC, University of Burgundy, Dijon, FranceLipness Team, INSERM Research Centre LNC-UMR1231 and LabEx LipSTIC, University of Burgundy, Dijon, FrancePneumocystis pneumonia (PcP) remains life-threatening in kidney transplant recipients (KTR). Our study investigated risk factors one-year before PcP. We conducted a monocentric, case-control study including all KTR at the Dijon University Hospital (France) with a diagnosis of PcP between 2005 and 2022 (cases), and matched control KTR with no history of PcP (3 controls/case). Among all 1,135 KTR, 57 cases (5%) and 169 matched-controls were included. PcP was associated with 18% mortality. Compared to controls, cases were older, with a higher immunological risk, and CMV infection was more frequent in the year preceding the occurrence of PcP (23% vs. 4%; p < 0.001). As early as 1 year before PcP, lymphocyte counts were lower and serum creatinine levels were higher in cases, but immunosuppressive regimens were not significantly different. Multivariable analysis identified lymphocyte count, serum creatinine level, being treated by immunosuppressive therapy other than anti-rejection drugs, and CMV infection in the year preceding the time PcP as independently associated with the occurrence of PcP. PcP was associated with an increased risk of subsequent chronic rejection (27% vs. 3%; p = 0.001) and return to dialysis (20% vs. 3%; p = 0.002). The occurrence of CMV infection and a low lymphocyte count could redefine the indications for continuation or reinitiation of anti-Pneumocystis prophylaxis.https://www.frontierspartnerships.org/articles/10.3389/ti.2024.12192/fullkidney transplantationpneumonialymphopeniapneumocystisCMV |
| spellingShingle | Isabelle Eberl Christine Binquet Christine Binquet Adrien Guilloteau Mathieu Legendre Frederic Dalle Frederic Dalle Lionel Piroth Lionel Piroth Lionel Piroth Claire Tinel Claire Tinel Mathieu Blot Mathieu Blot Mathieu Blot Mathieu Blot CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant Recipients Transplant International kidney transplantation pneumonia lymphopenia pneumocystis CMV |
| title | CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant Recipients |
| title_full | CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant Recipients |
| title_fullStr | CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant Recipients |
| title_full_unstemmed | CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant Recipients |
| title_short | CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant Recipients |
| title_sort | cmv infection and lymphopenia warning markers of pneumocystis pneumonia in kidney transplant recipients |
| topic | kidney transplantation pneumonia lymphopenia pneumocystis CMV |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.12192/full |
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