The impact of cytomegalovirus disease and asymptomatic infection on acute renal allograft rejection
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu klinické zkoušky, srovnávací studie, časopisecké články, randomizované kontrolované studie, práce podpořená grantem
PubMed
16531113
DOI
10.1016/j.jcv.2006.01.015
PII: S1386-6532(06)00045-X
Knihovny.cz E-zdroje
- MeSH
- acyklovir analogy a deriváty terapeutické užití MeSH
- akutní nemoc MeSH
- antivirové látky terapeutické užití MeSH
- cytomegalovirové infekce komplikace prevence a kontrola virologie MeSH
- Cytomegalovirus genetika izolace a purifikace MeSH
- ganciklovir terapeutické užití MeSH
- incidence MeSH
- lidé středního věku MeSH
- lidé MeSH
- multivariační analýza MeSH
- pooperační komplikace * prevence a kontrola MeSH
- přenašečství MeSH
- prospektivní studie MeSH
- rejekce štěpu epidemiologie etiologie MeSH
- rizikové faktory MeSH
- transplantace ledvin škodlivé účinky MeSH
- valaciclovir MeSH
- valin analogy a deriváty terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
- Názvy látek
- acyklovir MeSH
- antivirové látky MeSH
- ganciklovir MeSH
- valaciclovir MeSH
- valin MeSH
BACKGROUND: Cytomegalovirus (CMV) disease is a risk factor for allograft rejection in renal transplant (RTx) recipients. However, the role of asymptomatic CMV infection remains controversial. OBJECTIVES: To determine the impact of CMV disease and asymptomatic infection on biopsy-proven acute rejection (BPAR) during 12 months post-RTx. STUDY DESIGN: A total of 106 consecutive RTx recipients at risk for CMV (donor and/or recipient CMV seropositive) were followed prospectively for 12 months post-RTx. CMV activity was monitored using nested PCR from whole blood. Three-month prophylaxis with valacyclovir or ganciclovir was given to 94 patients. BPAR episodes were classified according to the Banff 97 criteria. Multivariate Cox proportional hazards model was used to estimate the effect of CMV disease, asymptomatic infection, and other covariates on BPAR. RESULTS: Asymptomatic CMV infection occurred in 23% of the patients and 10% developed CMV disease. The incidence of BPAR was 29%. CMV disease was an independent risk factor for BPAR (HR=3.0, P=0.014), while asymptomatic CMV infection was not (P=0.987). In addition to CMV disease, expanded criteria donor and donor age were independent predictors for BPAR. In univariate analysis, valacyclovir (HR=0.26, P=0.008) decreased the risk of BPAR. A similar trend was observed with ganciclovir (HR=0.42, P=0.058). Only valacyclovir remained significant in multivariate analysis (HR=0.18, P=0.044). CONCLUSIONS: CMV disease, but not asymptomatic infection, is an independent risk factor for BPAR during the first 12 months post-RTx.
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