Effectiveness of valacyclovir prophylaxis against the occurrence of cytomegalovirus infection in kidney transplant recipients.
Antibiotic prophylaxis
Antithymocyte serum
Cytomegalovirus infections
Kidney transplantation
Risk factors
Journal
Korean journal of transplantation
ISSN: 2671-8790
Titre abrégé: Korean J Transplant
Pays: Korea (South)
ID NLM: 101775609
Informations de publication
Date de publication:
31 Mar 2020
31 Mar 2020
Historique:
received:
14
11
2019
revised:
17
01
2020
accepted:
24
02
2020
entrez:
30
6
2022
pubmed:
31
3
2020
medline:
31
3
2020
Statut:
ppublish
Résumé
Cytomegalovirus (CMV) infection is a crucial infection in kidney transplant recipients (KTRs) despite advancements in diagnostic and treatment methods. There are still many controversies about the ways to prevent CMV infection. We retrospectively analyzed 153 KTRs who underwent kidney transplantation (KT) between September 2013 and January 2016. We classified KTRs into two groups: valacyclovir prophylaxis group (intravenous ganciclovir for 2 weeks after KT, followed by oral valacyclovir for 3 months) and historical control group (only intravenous ganciclovir for 2 weeks after KT). We evaluated the incidence of CMV infection, clinical outcomes, CMV-free survival rate between the two groups and risk factors for the development of CMV infection. Mean time between KT and diagnosis of CMV infection was 4.5±3.3 months. The valacyclovir prophylaxis group showed lower incidence of CMV infection than the historical control group (21.7% vs. 43.9%, P=0.011). The valacyclovir prophylaxis group showed higher CMV-free survival rate than the control group (P=0.011). In multivariable-adjusted analysis, independent risk factors for the development of CMV infection were no valacyclovir prophylaxis, older age at KT, thymoglobulin induction, and delayed graft function. Valacyclovir prophylaxis for 3 months showed significant reduction in the incidence of CMV infection in KTRs. Therefore, we suggest valacyclovir prophylaxis for 3 months in KTRs with risk factors such as old age, thymoglobulin induction, and delayed graft function.
Sections du résumé
Background
UNASSIGNED
Cytomegalovirus (CMV) infection is a crucial infection in kidney transplant recipients (KTRs) despite advancements in diagnostic and treatment methods. There are still many controversies about the ways to prevent CMV infection.
Methods
UNASSIGNED
We retrospectively analyzed 153 KTRs who underwent kidney transplantation (KT) between September 2013 and January 2016. We classified KTRs into two groups: valacyclovir prophylaxis group (intravenous ganciclovir for 2 weeks after KT, followed by oral valacyclovir for 3 months) and historical control group (only intravenous ganciclovir for 2 weeks after KT). We evaluated the incidence of CMV infection, clinical outcomes, CMV-free survival rate between the two groups and risk factors for the development of CMV infection.
Results
UNASSIGNED
Mean time between KT and diagnosis of CMV infection was 4.5±3.3 months. The valacyclovir prophylaxis group showed lower incidence of CMV infection than the historical control group (21.7% vs. 43.9%, P=0.011). The valacyclovir prophylaxis group showed higher CMV-free survival rate than the control group (P=0.011). In multivariable-adjusted analysis, independent risk factors for the development of CMV infection were no valacyclovir prophylaxis, older age at KT, thymoglobulin induction, and delayed graft function.
Conclusions
UNASSIGNED
Valacyclovir prophylaxis for 3 months showed significant reduction in the incidence of CMV infection in KTRs. Therefore, we suggest valacyclovir prophylaxis for 3 months in KTRs with risk factors such as old age, thymoglobulin induction, and delayed graft function.
Identifiants
pubmed: 35770264
doi: 10.4285/kjt.2020.34.1.15
pii: KJT-34-1-015
pmc: PMC9188953
doi:
Types de publication
Journal Article
Langues
eng
Pagination
15-23Informations de copyright
© The Korean Society for Transplantation.
Références
Cochrane Database Syst Rev. 2017 Jan 11;1:CD004759
pubmed: 28073178
Am J Transplant. 2002 Oct;2(9):850-6
pubmed: 12392291
Am J Transplant. 2009 Nov;9(11):2453-8
pubmed: 19843027
Am J Kidney Dis. 2011 Jul;58(1):118-26
pubmed: 21684438
Transplantation. 2013 Aug 27;96(4):333-60
pubmed: 23896556
Clin Infect Dis. 2017 Jan 1;64(1):87-91
pubmed: 27682069
N Engl J Med. 2007 Dec 20;357(25):2601-14
pubmed: 18094380
Am J Transplant. 2004 Apr;4(4):611-20
pubmed: 15023154
Am J Transplant. 2009 Nov;9 Suppl 3:S1-155
pubmed: 19845597
Transpl Infect Dis. 2015 Jun;17(3):334-41
pubmed: 25824586
Clin J Am Soc Nephrol. 2015 Feb 6;10(2):294-304
pubmed: 25424991
Nephrol Dial Transplant. 2013 Mar;28(3):758-65
pubmed: 23243043
Clin Transplant. 2016 Sep;30(9):1159-64
pubmed: 27423138
Am J Transplant. 2013 Mar;13 Suppl 4:93-106
pubmed: 23465003
N Engl J Med. 1999 May 13;340(19):1462-70
pubmed: 10320384
Transplantation. 2013 Dec 27;96(12):1097-103
pubmed: 24056621