Background/Aim: Cytomegalovirus (CMV) and Epstein–Barr virus (EBV) are major public health concerns because of their high worldwide prevalence and potential for serious clinical outcomes after transplantation. This study assessed CMV and EBV seroprevalence among renal transplant donors and recipients in Iraq and provided baseline epidemiological data to inform future strategies to reduce high-risk donor–recipient viral mismatches.
Methods: This retrospective cross-sectional serostatus study included 200 renal transplant donor–recipient pairs at Medical City Teaching Hospital and Al-Karama Teaching Hospital between January 2025 and July 2025, with posttransplant CMV DNA assessment in recipients during the first post-transplant year.
Results: Among 200 recipients, 126 (63.0%) were male, and 74 (37.0%) were female, with a mean age of 34.5 ± 12.4 years. CMV IgG seroprevalence was high in donors (87.0%) and recipients (83.5%). EBV IgG seroprevalence was approximately 51.0% in both groups. High-risk D+/R- serostatus was observed in 6.0% of CMV pairs and 3.0% of EBV pairs. Among recipients, CMV IgG prevalence was highest in the 41–50-year age group (90.4%), whereas EBV IgG prevalence was highest in the 21–30-year age group (61.7%). No significant association was found with age, sex, smoking, or hemodialysis duration. IgM detection was rare (2.5%) for both viruses. CMV DNA was detected in 21/200 recipients (10.5%) and was significantly associated with diabetes mellitus (p = 0.001).
Conclusion: CMV IgG seroprevalence was high, and EBV IgG seroprevalence was moderate among renal transplant donor– recipient pairs. Post-transplant CMV DNAemia was significantly associated with diabetes mellitus. These findings support routine pre-transplant serological screening, although further studies with standardized PCR monitoring are required.