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Risk of infectious diseases among first-degree relatives of transplant recipients who develop CMV infection: is the infectious phenotype inheritable?

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Abstract

Transplant recipients are at high risk of cytomegalovirus (CMV) infection. Mechanisms explaining the variation in risk of infections are far from fully elucidated. We hypothesised that host genetics explains part of the variation in risk of infection and examined if relatives of recipients with CMV infection have higher rates of severe infections compared to relatives of recipients without this infectious phenotype. In a register-based study, we included first-degree relatives of transplant recipients and examined the risk of hospitalisation due to overall infection or viral infection and risk of death among relatives of recipients who developed CMV infection within the first year of transplantation compared to relatives of recipients without CMV. Analyses were adjusted for sex, age and calendar year. We included 4470 relatives who were followed for 103,786 person-years, median follow-up 24 years [interquartile range (IQR) 12–36]. There were a total of 1360 infection-related hospitalisations in the follow-up period, incidence rate (IR) 13.1/1000 person-years [95% confidence interval (CI), 12.4; 13.8]. 206 relatives were hospitalised with viral infection, IR 1.8/1000 person-years (95% CI, 1.6; 2.0). There was no increased risk of hospitalisation due to infections, IR ratio (IRR) 0.99 (95% CI, 0.88; 1.12), nor specifically viral infections, IRR 0.87 (95% CI, 0.63; 1.19), in relatives of recipients with CMV compared to relatives of recipients without CMV. Also, no difference was seen in analyses stratified by transplant type, family relation and CMV serostatus. The risk of hospitalisation due to infection is not increased among first-degree relatives of transplant recipients with CMV infection compared to relatives of recipients without CMV.

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Authors and Affiliations

  1. Centre of Excellence for Health, Immunity and Infections (CHIP), Department of Infectious Diseases, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark

    C. Ekenberg, I. P. Lodding, N. E. Wareham, J. D. Lundgren & M. Helleberg

  2. Department of Nephrology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark

    S. S. Sørensen

  3. Department of Haematology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark

    H. Sengeløv

  4. Department of Cardiology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark

    F. Gustafsson & M. Perch

  5. Department of Surgery C, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark

    A. Rasmussen

Authors
  1. C. Ekenberg
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  2. I. P. Lodding
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  3. N. E. Wareham
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  4. S. S. Sørensen
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  5. H. Sengeløv
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  6. F. Gustafsson
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  7. A. Rasmussen
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  8. M. Perch
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  9. J. D. Lundgren
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  10. M. Helleberg
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Corresponding author

Correspondence to C. Ekenberg.

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Funding

This study was funded by the Danish National Research Foundation (grant number DNRF126). The funding source had no involvement in any part of the study design, data collection, data analysis and interpretation of the data or in the writing of this manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was performed in accordance with the Danish legislation and was approved by the Danish Data Protection Agency. Ethics approval was not needed for this type of study.

Informed consent

Not applicable. The study has a retrospective design.

Data availability

The data that support the findings of this study are available from the Centre of Excellence for Personalised Medicine of Infectious Complications in Immune Deficiency (PERSIMUNE) but restrictions apply to the availability of these data, which were used under licence for the current study, and, so, are not publicly available. The data are, however, available from the authors upon reasonable request and with the permission of PERSIMUNE.

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Ekenberg, C., Lodding, I.P., Wareham, N.E. et al. Risk of infectious diseases among first-degree relatives of transplant recipients who develop CMV infection: is the infectious phenotype inheritable?. Eur J Clin Microbiol Infect Dis 36, 2391–2398 (2017). https://doi.org/10.1007/s10096-017-3072-y

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  • DOI: https://doi.org/10.1007/s10096-017-3072-y

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