Abstract Title
Gastrointestinal viral Infection in Adult and Pediatric Solid Organ Transplant Recipient: A Retrospective, Single-center Study from 2015 to 2022
Presenter
Varalika Tyagi, University of Alberta
Co-Author(s)
'- Varalika Tyagi (1)
- Waiva Ann Galang – De Leon (1)
- Tanyapon Suandork (1)
- Catherine Burton (2)
- Xiao-Li Pang (3,4)
- Dima Kabbani (1,5)
(1) Division of Infectious Diseases, Department of Internal Medicine, University of Alberta, Edmonton, AB, Canada
(2) Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
(3) Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB, Canada
(4) Alberta Precision Laboratory, Edmonton, AB, Canada
(5) Li Ka Shing Institute of Virology (LKSIoV), University of Alberta, Edmonton, AB, Canada
Abstract Category
Epidemology
Abstract
INTRODUCTION
Gastrointestinal (GI) viruses are common causes of diarrhea in solid organ transplant recipients (SOT). Little is known of the difference in epidemiology, clinical presentation, and possible complications of gastrointestinal viruses between adult (A) and pediatric (P) solid organ transplant recipients.
METHODS
This is a single-center retrospective study of pediatric (less than or equal to 18 years old) and adult solid organ transplant recipients with a positive gastrointestinal viral Panel (GVP) assay result based on real-time quantitative polymerase chain reaction test from 2015-2022. The GVP assay detects 5 viruses: Norovirus (NoV), Rotavirus, Sapovirus (SaP), Astrovirus, and Adenovirus (Adv).
RESULTS
During the study period, 870 (P:8.2%) SOT had at least 1 GVP, and 194 (22.3%) tested positive for at least 1 virus. 178 SOT had 1 GI virus/GVP and 15 at least 2 viruses/GVP. Pediatrics were more likely to have positive GVP (P:48.6% vs A:16.8%), multiple viruses per GVP (P:18.1% vs A:1.6%), and multiple different viruses during the follow-up period (P:26.3% vs A:2.5%). NoV was the most common single virus in A (69.6%) and P (26.4%) followed by SaP (A:13.9%, P:13.9%). Chronic diarrhea (more than 14 days) was common in SOT with SaP (A:76.5%, P:70%), NoV (A:63.5%, P:42.1%), and Adv (A:46.2%, P:50%). NoV was associated with acute renal failure in (A:80%, P:36.8%), weight loss (A:45.9%, P:31%), and hospitalization (A:40%, P:26.3%). Treatment for NoV included antimotility drugs (A:75.2%, P:21.1%), oral immunoglobulin (A:36.5%, P:0), Nitazoxanide (A:9.4%, P:5.3%), and modification of immunosuppression (A:35.3%, P:10.5%).
CONCLUSION
Although NoV is the most common cause of GI viral infection in SOT, P-SOT had more diverse and mixed GI viral infections. Chronic diarrhea, weight loss, and modification in immunosuppression are common with NoV. Further studies are needed to assess the outcomes of GI viruses in SOT.
Gastrointestinal (GI) viruses are common causes of diarrhea in solid organ transplant recipients (SOT). Little is known of the difference in epidemiology, clinical presentation, and possible complications of gastrointestinal viruses between adult (A) and pediatric (P) solid organ transplant recipients.
METHODS
This is a single-center retrospective study of pediatric (less than or equal to 18 years old) and adult solid organ transplant recipients with a positive gastrointestinal viral Panel (GVP) assay result based on real-time quantitative polymerase chain reaction test from 2015-2022. The GVP assay detects 5 viruses: Norovirus (NoV), Rotavirus, Sapovirus (SaP), Astrovirus, and Adenovirus (Adv).
RESULTS
During the study period, 870 (P:8.2%) SOT had at least 1 GVP, and 194 (22.3%) tested positive for at least 1 virus. 178 SOT had 1 GI virus/GVP and 15 at least 2 viruses/GVP. Pediatrics were more likely to have positive GVP (P:48.6% vs A:16.8%), multiple viruses per GVP (P:18.1% vs A:1.6%), and multiple different viruses during the follow-up period (P:26.3% vs A:2.5%). NoV was the most common single virus in A (69.6%) and P (26.4%) followed by SaP (A:13.9%, P:13.9%). Chronic diarrhea (more than 14 days) was common in SOT with SaP (A:76.5%, P:70%), NoV (A:63.5%, P:42.1%), and Adv (A:46.2%, P:50%). NoV was associated with acute renal failure in (A:80%, P:36.8%), weight loss (A:45.9%, P:31%), and hospitalization (A:40%, P:26.3%). Treatment for NoV included antimotility drugs (A:75.2%, P:21.1%), oral immunoglobulin (A:36.5%, P:0), Nitazoxanide (A:9.4%, P:5.3%), and modification of immunosuppression (A:35.3%, P:10.5%).
CONCLUSION
Although NoV is the most common cause of GI viral infection in SOT, P-SOT had more diverse and mixed GI viral infections. Chronic diarrhea, weight loss, and modification in immunosuppression are common with NoV. Further studies are needed to assess the outcomes of GI viruses in SOT.