Distribution of Cytomegalovirus (CMV) glycoprotein B (gB) genotypes among renal and haematopoietic stem cell transplant (HSCT) recipients in a tertiary hospital, Kuala Lumpur, Malaysia

Introduction: Cytomegalovirus (CMV) glycoprotein B (gB), encoded by gpUL55, is crucial for CMV's cellular entry and a potential pathogenicity marker. We investigated CMV gB genotype distribution in renal and haematopoietic stem cell transplant (HSCT) recipients, assessing correlations with disease. Materials and methods: 264 clinical samples from 110 renal and 154 HSCT recipients at a tertiary hospital in Kuala Lumpur, Malaysia were analysed. Quantitative PCR detected four CMV gB genotypes (gB1-4), and clinical data correlations were assessed. CMV serostatus of donors (D) and recipients (R) was determined pre-transplantation. Results: In renal transplant recipients, 48.2% exhibited single-genotype CMV, with gB2 (20.9%) and gB1 (17.3%) most prevalent. HSCT recipients showed 47.3% single-genotype CMV, primarily gB2 (20.7%) and gB1 (17.0%). Mixed-genotype infections were observed in 51.8% of renal transplant and 52.7% of HSCT recipients, particularly gB1-gB2 (65.8%). Mixed gB genotypes showed no significant CMV disease association in renal transplant recipients (p = 0.307) and HSCT recipients (p = 0.176). Virus load comparisons indicated significant differences in both groups, but renal transplant recipients with mixed infections had a higher median viral load. The majority of both recipient groups were D+/R+ (84.5% renal, 79.2% HSCT). Primary diagnoses among recipients varied, including glomerulonephritis, diabetes mellitus, hypertension, acute leukemias, lymphomas, and other conditions. Conclusion: This study reveals the diversity of CMV genotypes in renal and HSCT transplant recipients and their potential impact on disease correlation, providing insights into genotype prevalence, viral load association, and CMV disease risk.

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