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Background: Epstein‐Barr virus (EBV) can cause severe disease following hematopoietic stem cell transplant (HSCT), including post‐transplant lymphoproliferative disorder (PTLD). The objective was to analyze risk factors associated with post‐transplant EBV outcomes among pediatric allogeneic HSCT recipients. Methods: We used data from 156 pediatric allogeneic HSCT recipients enrolled in the Canadian multicenter TREASuRE study. Cox and Prentice‐Williams‐Petersen models were used to analyze risk factors for post‐transplant EBV events including occurrence and recurrence of EBV DNAemia, increase in EBV viral load (EBV‐VL), and preemptive use of rituximab, an effective therapy against PTLD. Results: Females were at higher risk for increasing EBV‐VL (adjusted hazard ratio (HR) = 2.83 [95% confidence intervals (CI): 1.33–6.03]) and rituximab use (HR = 3.08 [1.14–8.30]), but had the same EBV DNAemia occurrence (HR = 1.21 [0.74–1.99]) and recurrence risks (HR=1.05 [0.70–1.58]) compared to males. EBV DNAemia was associated with recipient pre‐transplant EBV seropositivity (HR = 2.47 [1.17–5.21]) and with graft from an EBV‐positive donor (HR = 3.53 [1.95–6.38]). Anti‐thymocyte globulin (ATG) was strongly associated with all EBV outcomes, including the use of rituximab (HR = 5.33 [1.47–19.40]). Mycophenolate mofetil (MMF) significantly decreased the risk of all EBV events including the rituximab use (HR = 0.13 [0.03–0.63]). Conclusion: This study in pediatric allogeneic HSCT patients reveals a reduced risk of all EBV outcomes with the use of MMF. Risk factors for EBV events such as EBV‐VL occurrence and recurrence include EBV positivity in the donor and recipient, and use of ATG, whereas risk factors for the most severe forms of EBV outcome (EBV‐VL and the use of rituximab) include female sex and ATG use. [ABSTRACT FROM AUTHOR]

Background Epstein-Barr virus (EBV) is implicated in the progression of chronic obstructive pulmonary disease. We aimed to determine whether EBV correlates with bronchiectasis severity, exacerbations, and progression. Methods We collected induced sputum in healthy controls and spontaneous sputum at 3–6-month intervals and onset of exacerbations in bronchiectasis patients between March 2017 and October 2018. EBV DNA was detected with quantitative polymerase chain reaction. Results We collected 442 sputum samples from 108 bronchiectasis patients and 50 induced sputum samples from 50 healthy controls. When stable, bronchiectasis patients yielded higher detection rates of EBV DNA (48.1% vs 20.0%; P =.001), but not viral loads (mean log10 load, 4.45 vs 4.76; P =.266), compared with controls; 64.9% of patients yielded consistent detection status between 2 consecutive stable visits. Neither detection rate (40.8% vs 48.1%; P =.393) nor load (mean log10 load, 4.34 vs 4.45; P =.580) differed between the onset of exacerbations and stable visits, nor between exacerbations and convalescence. Neither detection status nor viral loads correlated with bronchiectasis severity. EBV loads correlated negatively with sputum interleukin-1β (P =.002), CXC motif chemokine-8 (P =.008), and tumor necrosis factor–α levels (P =.005). Patients initially detected with, or repeatedly detected with, EBV DNA had significantly faster lung function decline and shorter time to next exacerbations (both P <.05) than those without. Detection of EBV DNA was unrelated to influenza virus and opportunistic bacteria (all P >.05). The EBV strains detected in bronchiectasis patients were phylogenetically homologous. Conclusions Patients with detection of EBV DNA have a shorter time to bronchiectasis exacerbations. EBV may contribute to bronchiectasis progression. [ABSTRACT FROM AUTHOR]