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Cytomegalovirus prevention strategies and the risk of BK polyomavirus viremia and nephropathy
T. Reischig, M. Kacer, O. Hes, J. Machova, J. Nemcova, D. Lysak, P. Jindra, K. Pivovarcikova, S. Kormunda, M. Bouda,
Language English Country United States
Document type Journal Article, Research Support, Non-U.S. Gov't
Grant support
LO1503
National Sustainability Program I - International
Ministry of Education, Youth and Sports of the Czech Republic - International
Charles University Research Fund - International
CZ.02.1.01/0.0/0.0/16_019/0000787
Fighting INfectious Diseases - International
European Regional Development Fund - International
NLK
Free Medical Journals
from 2001 to 2022
ROAD: Directory of Open Access Scholarly Resources
from 2001
PubMed
31220412
DOI
10.1111/ajt.15507
Knihovny.cz E-resources
- MeSH
- Kidney Failure, Chronic complications surgery MeSH
- Cytomegalovirus Infections prevention & control MeSH
- Cytomegalovirus MeSH
- Adult MeSH
- Tumor Virus Infections prevention & control MeSH
- Middle Aged MeSH
- Humans MeSH
- Multivariate Analysis MeSH
- Polyomavirus Infections virology MeSH
- Premedication MeSH
- Graft Survival MeSH
- Proportional Hazards Models MeSH
- Prospective Studies MeSH
- Randomized Controlled Trials as Topic MeSH
- Risk Factors MeSH
- Kidney Transplantation adverse effects MeSH
- Valacyclovir therapeutic use MeSH
- Valganciclovir therapeutic use MeSH
- Viremia etiology MeSH
- BK Virus MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Polyomavirus BK (BKV) is the cause of polyomavirus-associated nephropathy resulting in premature graft loss. There are limited data regarding the role of cytomegalovirus (CMV) infection and its prevention in developing BKV viremia and PVAN. In a prospective study, we analyzed 207 consecutive renal transplant recipients previously enrolled in 2 randomized trials evaluating different CMV prevention regimens with routine screening for BKV and CMV. Of these, 59 received valganciclovir and 100 valacyclovir prophylaxis; 48 patients were managed by preemptive therapy. At 3 years, the incidence of BKV viremia and PVAN was 28% and 5%, respectively. CMV DNAemia developed in 55% and CMV disease in 6%. Both BKV viremia (42% vs 23% vs 21%, P = .006) and PVAN (12% vs 2% vs 2%, P = .011) were increased in patients treated with valganciclovir prophylaxis compared to valacyclovir and preemptive therapy. Using multivariate Cox proportional hazard regression, valganciclovir prophylaxis was independent predictor of BKV viremia (hazard ratio [HR] = 2.38, P = .002) and PVAN (HR = 4.73, P = .026). In contrast, the risk of subsequent BKV viremia was lower in patients with antecedent CMV DNAemia (HR = 0.50, P = .018). These data suggest valganciclovir prophylaxis may be associated with increased risk of BKV viremia and PVAN. CMV DNAemia did not represent a risk for BKV.
References provided by Crossref.org
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