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Cancer risk associated with cytomegalovirus infection among solid organ transplant recipients in the United States
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11 15 2022
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Source: Cancer. 128(22):3985-3994
[PDF-475.21 KB]
Details:
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Alternative Title:Cancer
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Personal Author:
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Description:Background:
Cytomegalovirus (CMV) is among the most common viral infections following solid organ transplantation (SOT). Associations of CMV with cancer risk among SOT recipients have been incompletely evaluated.
Methods:
We used linked data from the United States SOT registry and 32 cancer registries. We used Poisson regression to compare cancer incidence across CMV risk groups based on donor (D) and recipient (R) IgG serostatus: high-risk (R−/D+), moderate-risk (R+), and low-risk (R−/D−).
Results:
We evaluated 247,318 SOT recipients during 2000–2017 (20.3% CMV R−/D+, 62.9% R+, 16.8% R−/D−). CMV seropositive recipients were older, more racially/ethnically diverse, and had lower socioeconomic status than seronegative recipients. Compared to CMV R−/D− recipients, R−/D+ and R+ recipients had lower incidence of diffuse large B-cell lymphoma (DLBCL; (adjusted incidence rate ratio [aIRR]:0.74, 95% confidence interval [CI]: 0.59-0.91, and 0.83, 0.69-1.00, respectively). CMV serostatus modified the association between EBV status and DLBCL (p=0.0006): DLBCL incidence was increased for EBV R−/D+ recipients (aIRR: 3.46, 95%CI: 1.50-7.95) among CMV R−/D− recipients but not among other CMV risk groups. Compared to CMV R−/D− recipients, R−/D+ recipients had lower incidence of small intestine cancer (aIRR: 0.23, 95%CI: 0.09-0.63), and R+ recipients had higher incidence of lung cancer (1.24, 1.05-1.46). CMV status was not associated with risk for other cancers.
Conclusions:
CMV status was not associated with risk for most cancers among SOT recipients. The inverse association with DLBCL may reflect protective effects of CMV prophylaxis or treatment with off-target efficacy against EBV infection (the major cause of lymphoma in SOT recipients).
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Pubmed ID:36126024
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Pubmed Central ID:PMC9633408
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