Article Abstract:
The prevalence of infections with retroviruses in kidney transplant recipients was examined. Blood samples from 224 patients undergoing kidney transplantation between 1979 and 1985 were tested for the presence of human immunodeficiency virus (HIV) and human T-cell leukemia virus type I (HTLV-I). Four patients were infected with HIV-1 and two with HTLV-I. All four patients with HIV infection had no evidence of the infection before transplantation, but briefly developed HIV-1 antigenemia, the presence of portions of HIV in the blood that may cause an immune or natural defense reaction. One HIV-1-infected patient with retroviral infection died two years after transplantation, from Kaposi's sarcoma, cancerous growths on the skin and other body sites. Another HIV-1-infected patient remains alive with no symptoms after four years, whereas two other HIV-1-infected patients rejected their transplanted kidneys and are without symptoms, but require hemodialysis to filter their blood. Of the two patients with HTLV-I infection, the retrovirus was detected in one patient before transplantation and in the other patient after receiving the transplant. Both HTLV-I-infected patients are without symptoms three years after kidney transplantation. Intravenous drug use was not a risk factor in these patients, and retroviral infection probably did not result from blood transfusions during transplantation. However, transmission of retroviruses through contaminated donor kidneys should be considered as a cause of retroviral infection. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
A major and sometimes fatal complication of bone marrow transplantation is infection with cytomegalovirus (CMV), which is a form of herpes virus. In recurrent infection with CMV, antibodies - specifically immunoglobulins - develop and they are of three basic types: IgA, IgM, and IgG. In order to evaluate the incidence of production of these three immunoglobulins in response to recurrent CMV infection in patients who have undergone bone marrow transplant (BMT), 21 BMT patients who were CMV seropositive (i.e. had antibodies to the virus) but had not previously had CMV were studied. Seventeen patients were infected with CMV, of whom 16 secreted CMV virus in their urine. Fifteen had detectible levels of IgA, 13 had levels of IgM, and the levels of IgG quadrupled in 11 cases. The patients began to excrete virus in their urine an average of 69 days after the transplant, and while the elevated levels of IgA and IgM receded after about 14 and 30 days, respectively, the high levels of IgG tended to persist. It was also found that in the 12 patients who actually developed CMV disease, levels of IgA and IgM increased before the appearance of elevated IgG levels. The results suggest that IgA and IgM levels may be diagnostically relevant for BMT patients who have a history of recurrent CMV infection. (Consumer Summary produced by Reliance Medical Information, Inc.)
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Article Abstract:
The use of immunosuppressive drugs among renal transplant recipients have increased the incidence of opportunistic infections such as laryngeal tuberculosis in such patients. Thus, clinicians must consider laryngeal tuberculosis as a differential diagnosis for renal transplant recipients complaining of hoarseness. Two renal transplant recipients who were found to be positive for the acid-fast bacilli have responded well to tuberculosis drug therapy.
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