HCMV can be reactivated after kidney transplant, and it can be dangerous

HCMV is a common viral infection and the majority of people in the UK have been infected with it at some point in their lives. In healthy people, the immune system controls the virus, it rarely causes illness, and most people don’t even know they have been infected. However, it is never fully cleared from the body. This means it can ‘reactivate’ and cause symptoms if something suppresses the immune system. 

People with a transplant can develop HCMV disease due to reactivation of the virus already in their body, or due to virus carried in the new kidney from the donor. Without treatment, HCMV can cause a severe illness affecting many different organs. We currently don’t know who will go on to develop HCMV disease after transplant so all patients are given anti-viral medication for the first few months following their transplant, but these drugs can have nasty side effects.  

We desperately need a better way of identifying which patients are at risk of developing HCMV disease, so we only give anti-viral drugs to people who need them. We have awarded Eddie with a Research Project Grant to answer this question. 

How can we tell which patients will develop HCMV?

Eddie and his team will analyse the whole genetic code of viruses from different patients to find out whether genetic differences in the viruses can explain the differences in the severity of the disease. The team will also study immune cells called natural killer (NK) cells. In healthy people, these cells help to control the virus and the team will investigate whether differences in the number and type of NK cells affect a patient’s ability to control HCMV infection. They will also look at how genetic differences in HCMV link up with differences in NK cells. 

What does this mean for kidney patients?

This research will reveal factors in HCMV and/or the patient that can predict who will get disease, and why. With this knowledge, healthcare professionals should ultimately be able to prescribe anti-viral drugs only for those who need them and avoid unnecessary treatment for those who do not. 

“We are delighted to receive grant funding from Kidney Research UK for this study,” Eddie said. “Some, but not all, kidney transplant recipients will have severe disease due to HCMV reactivating in their bodies. This research will allow us to work out which patients will reactivate HCMV, and why. It should help us predict which patients need anti-viral drugs, sparing those who do not from the unpleasant side effects, and may ultimately enable us to stop HCMV from reactivating in the first place.” 

Eddie’s work is funded by a research project grant from Kidney Research UK for £210,000