Human cytomegalovirus-viruria in hematopoietic stem cell transplant recipients: Context and impact

Infect Dis Now. 2023 Apr;53(3):104651. doi: 10.1016/j.idnow.2023.104651. Epub 2023 Jan 23.

Abstract

Background: Episodes of CMV-viruria have been reported in hematopoietic stem cell transplant (HSCT) recipients, but their context of occurrence, pathophysiology, and clinical significance remain misunderstood.

Methods: Uurine samples from 517 recipients were collected. Clinical features of recipients with or without episodes of CMV-viruria were retrospectively compared.

Results: CMV-viruria was detected in 15.5 % of cases. Age, sex, type of transplantation, HLA-matching, conditioning regimen, and immunosuppressive therapies did not differ between patients with and without CMV-viruria. CMV-seropositive status (R + ) was more frequent among CMV-viruric recipients. Cumulated mortality did not differ between the two groups but graft-versus-host diseases occurred more frequently among CMV-viruric patients (p = 0.04). No reduction of the estimated glomerular filtration rates was observed in CMV-viruric recipients.

Conclusions: CMV-viruria primarily occurs in CMV-seropositive recipients and is not related to the degree of immunosuppression. We suggest that CMV-viruria is primarily related to the inability of the graft immune system to contain CMV-replication in R + patients. CMV-viruria is not associated with increased mortality or renal dysfunction.

Keywords: Cytomegalovirus; Hematopoietic Stem Cell Transplantation; Viruria.

MeSH terms

  • Cytomegalovirus
  • Cytomegalovirus Infections* / drug therapy
  • Cytomegalovirus Infections* / epidemiology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Kidney Diseases* / etiology
  • Retrospective Studies