Background: Cytomegalovirus (CMV) is the most common cause of viral infection, causing morbidity and mortality among kidney transplant recipients (RTRs). Cytokines such as tumor necrosis factor- Α (TNF-Α), interleukin-10 (IL10), and interferon-Γ (IFN-Γ) have been shown to possess antiviral properties and their polymorphisms are associated with disease outcome. The aim was to investigate the association of gene polymorphisms in the IL10, IFN-Γ, TNF-Α, and toll-like receptor 2 (TLR2) with CMV viremia in RTRs.

Methods: IL10 (-1082 A>G, -592 A>C); TNF-Α -308 A>G; IFN-Γ +874 A>T; and TLR2- Arg753Gln G>A gene polymorphisms were studied in 237 RTRs (52 RTRs with CMV viremia and 185 without CMV viremia), using DNA-based polymerase chain reaction with sequence-specific primers and restriction. Stepwise logistic regression analysis was used to generate univariate and multivariate odd ratios to validate the significance of trends.

Results: Median time to CMV viremia was 6 months with a mean peak CMV viral load of 7925 copies per ml. Patients with donor-positive/recipient-negative [D+/R-] serostatus were found to be associated with a high risk of CMV viremia (p=0.001). A statistically significant correlation was found between IFN-Γ +874 A>T polymorphism and the risk of the CMV infection. The IFN-Γ +874 A allele (AA + AT) genotype was associated with a higher risk of CMV viremia (OR: 3.2, 95% CI: 1.2-8.5, p=0.01) while the high producer IFN-Γ+874 TT genotype was associated with a lower risk of CMV viremia (OR:0.31, 95%CI:0.11-0.83, p=0.015). The allelic as well as genotypic frequencies of TNF-Α, IL-10 and TLR2 did not significantly differ between CMV viremia and control group.

Conclusion: IFN-Γ gene polymorphisms could be an important risk factor for CMV infection, whereas the high producer IFN-Γ+874 TT genotype appears to be a marker for protection against CMV viremia by inhibiting the viral replication.

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