Repository logo
 
Publication

Late Cytomegalovirus Infection in Kidney Transplant Recipients after a Six-Month Prevention Protocol

dc.contributor.authorCunha, L
dc.contributor.authorLaranjinha, I
dc.contributor.authorBirne, R, et al.
dc.date.accessioned2019-05-13T11:30:38Z
dc.date.available2019-05-13T11:30:38Z
dc.date.issued2019
dc.description.abstractBACKGROUND: Despite a reduction in the incidence of cytomegalovirus (CMV) infections after kidney transplantation, less is known about late CMV infection in kidney transplant recipients. OBJECTIVE: To assess incidence of CMV infection in a cohort of patients under a high surveillance CMV prevention protocol and identify factors associated with late CMV infection. METHODS: Analysis of a consecutive cohort of 181 kidney allograft recipients between January 2012 and Aug 2015. CMV prevention-protocol consisted of 6-month universal prophylaxis and pre-emptive therapy for high-risk group (D+/R- or patients submitted to lymphocyte-depleting agent for induction or rejection treatment) and pre-emptive therapy for standard-risk group (D±/R+). Stopping valganciclovir was followed by CMV screening in the next two appointments. RESULTS: CMV infection was identified in 73 of 181 patients; the rate in high-risk group and standard-risk group was similar (p=0.443). However, in the latter group, the infection occurred mostly in the first 6 months. Late CMV infection occurred in 25 of 181 patients (5 of standard-risk group and 20 of high-risk group), after a median (IQR) of 253 (230.3-312.3) days after transplantation and 55 (41-89.5) days after the protocol period. Screening for CMV after valganciclovir discontinuation revealed 56% of late CMV infections. In high-risk group, D+/R- was associated with late CMV infection (HR 2.7, p=0.039) and in standard-risk group; lower age was associated with late CMV infection (HR 0.89, p=0.02). CONCLUSION: The incidence of CMV infection was similar to that reported in the literature. In high-risk patients, antigenemia surveillance during prophylaxis did not appear to reduce late CMV infections. Antigenemia screening after valganciclovir had limited results in the diagnosis of late CMV infection. D+/R- was associated to late CMV infection in high-risk group. Lower age appeared to influence late CMV infection in standard-risk group.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInt J Organ Transplant Med. 2019;10(1):1-12pt_PT
dc.identifier.issn2008-6490
dc.identifier.urihttp://hdl.handle.net/10400.10/2239
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAvicenna Organ Transplantation Institutept_PT
dc.relation.publisherversionhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416999/pdf/ijotm-10-001.pdfpt_PT
dc.subjectCytomegalovirus infectionspt_PT
dc.subjectKidney transplantationpt_PT
dc.subjectRisk factorspt_PT
dc.titleLate Cytomegalovirus Infection in Kidney Transplant Recipients after a Six-Month Prevention Protocolpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlaceShirazpt_PT
oaire.citation.titleInternational journal of organ transplantation medicinept_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

Files

Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
Int J Organ Transplant Med. 2019.pdf
Size:
1.08 MB
Format:
Adobe Portable Document Format
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description: