Association of tumour necrosis factor alpha and interleukin 6 levels with cytomegalovirus DNA detection and disease after renal transplantation

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Abstract
Cytokines such as tumour necrosis factor alpha (TNF‐α) and interleukin 6 (IL‐6) are thought to be important in the pathogenesis of post‐transplant cytomegalovirus (CMV) disease. CMV infection increases the production of TNF‐α and IL‐6. Conversely, TNF‐α switches on the replication of CMV. To study the association of these two cytokines with CMV activity and disease, TNF‐α and IL‐6 levels were assayed in plasma samples taken serially from three groups of renal transplant recipients. Group A (n = 12) had CMV disease and syndrome; Group B (n = 11) had detectable CMV DNA in plasma or peripheral blood leucocytes without disease, i.e., presumed asymptomatic CMV infection, and Group C (n = 11) had no detectable CMV DNA nor disease. The median peak TNF‐α levels in patients with CMV disease (Group A) were significantly higher than that in Group B or Group C (P < 0.02) whereas the median peak IL‐6 levels in group C patients were significantly lower than that in group A (P < 0.04) or group B (P < 0.03). A TNF‐α level of above 100 pg/ml was significantly associated with CMV disease and high plasma CMV load (> 10,000 copies/ml). IL‐6 levels above 15 pg/ml were significantly associated with CMV DNA detection, but not with CMV disease or elevated CMV load. High levels of TNF‐α or IL‐6 were not associated with CMV donor/recipient serostatus, HHV‐6 or HHV‐7 DNA detection, immunosuppressive regimen or rejection episodes. The role of TNF‐α in the pathogenesis of CMV disease deserves further investigation. J. Med. Virol. 64:29–34, 2001.

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