Prevalence of herpesviruses at onset of idiopathic nephrotic syndrome

Background Idiopathic nephrotic syndrome (INS) is likely a primary immune disorder, but viruses might also be involved in the mechanisms of the disease. Here, we investigate the link between herpesvirus infection and the first manifestation of INS in children. Methods A prospective, multicentre, and population-based case-control study called NEPHROVIR included 164 patients, aged 6 months to 15 years old, newly diagnosed with INS, and 233 controls matched for gender, age, and period of sample. The analysis was done on 124 patients and 196 controls. Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus-6 (HHV-6), and human herpesvirus-7 (HHV-7) DNA prev alence at diagnosis were assessed from whole peripheral blood samples, as well as EBV and CMV viral load and seroprevalence. Results EBV DNA was significantly more prevalent in cases than in controls (50.8 vs 29.1 %; OR=2.6; p=0.0002), with no difference in viral load. A significant difference was also found for CMV (11.3 vs 3.6 %; p=0.02) and HHV-7 (83 vs 72 %; p=0.02) DNA prevalence between cases and controls. There were significantly more EBV and CMV recent infections or reactivations based on VCA-IgM and CMV IgM in cases than controls, while there were no differences in IgG seroprevalence. Conclusion The prevalence of positive EBV DNA detection and recent infection or reactivation is higher in children at onset of INS compared to a population matched for age, gender, and time of sampling. Keywords Epstein-barr virus * Cytomegalovirus * Steroid-sensitive nephroticsyndrome * Proteinuria Nephrovir
Introduction Steroid-sensitive idiopathic nephrotic syndrome (INS) is likely a primary immune disorder since proteinuria is fully sensitive to prednisone, and numerous immunosuppressive drugs have the ability to control the occurrence [...]