The role of viral load in the diagnosis, management, and possible prevention of Epstein-Barr virus–associated posttransplant lymphoproliferative disease following solid organ transplantation

Recent observations have identified an association between a high viral load of Epstein-Barr virus (EBV) in the peripheral blood and the presence of posttransplant lymphoproliferative disease. Both semiquantitative and quantitative polymerase chain reaction assays have been used to measure the EBV viral load. As a consequence, there has been a growing interest in the use of these assays for diagnosing posttransplant lymphoproliferative disease. A potentially more important development is the use of monitoring of the EBV viral load to prompt preemptive therapy against the development of clinical disease. In addition, serial measurement of the EBV viral load after the diagnosis of EBV/posttransplant lymphoproliferative disease may also provide useful information on the clinical status and response to treatment of symptomatic patients.