Clinical

New arenavirus linked to fatal transplant-associated diseases

Last Updated: 2008-02-06 17:00:39 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Using a powerful tool called unbiased high-throughput sequencing, researchers from Australia and the US identified a new arenavirus that was associated with a fatal febrile illness in three transplant recipients.

Arenaviruses, which are enveloped, negative-strand RNA viruses found in rodents, are typically transmitted to humans through contact with infected urine, according to the report in the February 6th Online First issue of The New England Journal of Medicine.

The most commonly implicated arenavirus, lymphocytic choriomeningitis virus (LCMV), usually causes mild illness, although fatal cases have been reported, including ones related to transplants.

In the present report, two of the patients had received a kidney transplant and one had received a liver transplant from the same donor, note study co-author Dr. Mike Catton, from the Victorian Infectious Diseases Reference Laboratory in Victoria, Australia, and colleagues. Four to six weeks after transplantation, all of the subjects had died from a febrile illness.

Applying high-throughput sequencing to RNA obtained from liver and kidney transplants in two of the recipients yielded 103,632 sequences, including 14 indicative of an Old World arenavirus. Further testing showed that this newly identified virus was present in the kidneys, liver, blood, and cerebrospinal fluid of recipients and that it was similar to LCMV.

Dr. Catton's team notes that had it not been for high-throughput sequencing, the identity of the responsible pathogen would have remained a mystery. "This technique may prove useful as a new tool in the identification and surveillance of pathogens in chronic as well as acute disease."

N Engl J Med 2008;358.