Increased EBV DNAemia after Anti-SARS-CoV-2 Vaccination in Solid Organ Transplants

"Abstract

... Assessing the potential impact of SARS-CoV-2 vaccinations on EBV infections in stable kidney and liver transplant recipients was the objective of our study. Ten solid-organ-transplant (SOT) patients (eight kidney and two liver) vaccinated with standard doses of mRNA COVID-19 vaccines were included. EBV DNA viral load measurements were conducted prior to the vaccination and during a follow-up period (at the first month and after six months) after the second vaccine dose. After the second dose, a significant increase in median viremia was observed (p < 0.01) in 9 patients, and in one patient, the reactivation of EBV infection was found. Six months later, the median viremia decreased significantly (p < 0.05). The EBV viral load should be closely monitored as it could lead to the earlier diagnosis and treatment of EBV-related complications. Despite experiencing a decrease in the viral load six months post-vaccination, some patients still had a viral load over the baseline, which increased the risk of potential complications.

1. Introduction

... Epstein–Barr virus (EBV) belongs to a human herpes virus family. It is typically latent in more than 90% of the global population, but in SOT recipients, post-transplant EBV infection or EBV reactivation can cause serious complications, including the worsening of the graft function and post-transplant lymphoproliferative disease (PTLD). The main risk factor of EBV infection is associated with the net strength of the immunosuppressive regimen, the reduction of which is also the key strategy for treatment. According to the recent literature, vaccination for SARS-CoV-2 in the general population has resulted in the reactivation of other herpes viruses, including cytomegalovirus and varicella zoster virus, in the general population. Moreover, rapidly growing EBV-positive lymphoma were reported seven days after the first dose of a COVID-19 vaccine...

5. Conclusions