Evidence map›Paper›PMID 36000190›Full record

ArticleTransplant infectious disease : an official journal of the Transplantation Society2022

Combined assessment of Epstein-Barr virus viral capsid antigen and Epstein-Barr virus nuclear antigen-1 serology for post-transplant lymphoproliferative disorder risk stratification in adult solid organ transplant recipients.

Madeleine R Heldman, Kerstin L Edlefsen, Gregory Pepper, Siddhartha G Kapnadak, Robert M Rakita, Cynthia E Fisher, Ajit P Limaye

Open access · greenAbstract read
In one paragraph

Article in Transplant infectious disease : an official journal of the Transplantation Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Review
  3. Epidemiology of Infections in Lung Transplant Recipients Treated With Belatacept.Transplant infectious disease : an official journal of the Transplantation Society
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Madeleine R HeldmanDivision of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-9424-1870
Kerstin L EdlefsenDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
Gregory PepperDepartment of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
Siddhartha G KapnadakDivision of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.
Robert M RakitaDivision of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0001-8105-8455
Cynthia E FisherDivision of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA.
Ajit P LimayeDivision of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA.
University of Washington · US

Funding

Training Program in Infectious Diseases in the Immunocompromised HostT32AI118690 · NIAID · FRED HUTCHINSON CANCER RESEARCH CENTER · PI BOECKH, MICHAEL J · 2016 to 2025
$4.0M
Respiratory Viral Determinants of Chronic Lung Allograft DysfunctionK23HL143050 · NHLBI · UNIVERSITY OF WASHINGTON · PI FISHER, CYNTHIA E · 2018 to 2022
$986k
National Institute of Allergy and Infectious Diseases T32AI118690NHLBI NIH HHS HL143050NHLBI NIH HHS K23 HL143050NIAID NIH HHS T32 AI118690
6 · The paper itself

Abstract

backgroundEpstein-Barr virus (EBV) seronegative solid organ transplant recipients (SOTRs) are at increased risk for post-transplant lymphoproliferative disorder (PTLD). Assays for EBV serostatus assess antibody to both EBV viral capsid antigen (VCA) and Epstein-Barr nuclear antigen-1 (EBNA-1), but PTLD risk among SOT recipients with discordant VCA and EBNA-1 results is unknown.

methodsWe performed a retrospective, single-center cohort study to determine the risk of PTLD among adult (≥ 18 years) SOTRs with discordant pre-transplant VCA and EBNA-1 IgG compared to that of SOTRs with concordantly negative or concordantly positive serology using univariable and multivariable Cox-proportional hazards models.

resultsOf 4106 SOTRs, the number (%) who were concordantly positive, concordantly negative, and discordant was 3787 (92.2%), 149 (3.6%), and 170 (4.2%), respectively. The adjusted hazard of PTLD was significantly higher among discordant SOTRs compared to concordantly positive SOTRs (aHR 2.6, 95% CI 1.04-6.6, p =.04) and lower compared to concordantly negative SOTRs (aHR 0.27, 95% CI 0.10-0.76, p <.001). The adjusted hazard of EBV+ PTLD among those with discordant serology was also significantly higher compared to the concordantly positive cohort (aHR 3.53, 95% CI 1.04-12.0, p =.04) and significantly lower compared to the concordantly negative cohort (aHR 0.23, 95% CI 0.06-0.82, p =.02).

conclusionsRisk of PTLD among SOTRs with discordant VCA and EBNA-1 may be intermediate between those with concordantly positive and negative serology. If confirmed in future studies, revision of national EBV serology reporting to include both VCA and EBNA results may be needed to optimize PTLD risk stratification.

Indexed as

Epstein-Barr Virus InfectionsLymphoproliferative DisordersOrgan TransplantationAdultCapsidCohort StudiesEpstein-Barr Virus Nuclear AntigensHerpesvirus 4, HumanHumansRetrospective StudiesRisk AssessmentEBV-encoded nuclear antigen 1Epstein-Barr Virus Nuclear AntigensEBVEpstein-Barr nuclear antigenPTLDserologyviral capsid antigen

Identifiers

PMID36000190
PMCPMC9780159
OpenAlexW4292877451

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.