Risk Factors for Cytomegalovirus Viremia following Liver Transplantation With a Seropositive Donor and Seronegative Recipient Receiving Antiviral Therapy
| Autor: | Nina Singh, Ajit P. Limaye, Marilyn M. Wagener, Raymund R. Razonable, G. Marshall Lyon, Fernanda P. Silveira, Drew J. Winston |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment Congenital cytomegalovirus infection Cytomegalovirus Viremia 030230 surgery Liver transplantation Gastroenterology Antiviral Agents law.invention 03 medical and health sciences Major Articles and Brief Reports 0302 clinical medicine Randomized controlled trial law Risk Factors Internal medicine medicine Immunology and Allergy Humans Ganciclovir business.industry Age Factors virus diseases Valganciclovir Odds ratio medicine.disease Confidence interval Tissue Donors Liver Transplantation 030104 developmental biology Infectious Diseases Cytomegalovirus Infections Population study business medicine.drug |
| Zdroj: | J Infect Dis |
| Popis: | Background The risk factors for development of viremia in high-risk donor cytomegalovirus (CMV)-seropositive and recipient CMV-seronegative (D+R−) transplant recipients are incompletely defined. Methods The study population comprised patients in the preemptive therapy (PET) arm of a randomized, controlled trial of PET versus prophylaxis using valganciclovir in D+R− liver transplant recipients. Weekly surveillance monitoring for viremia for 100 days was performed using a sensitive CMV-DNA polymerase chain reaction assays. Risk factors for viremia and time to onset (≤4 vs >4 weeks) of viremia were examined using logistic regression models. Results Viremia developed in 84% (79/94) of recipients and older donor age was the only independent factor associated with viremia (odds ratio, 2.20 for each quartile increase in donor age; 95% confidence interval [CI], 1.07–4.52; P = .031). Recipients who developed early-onset viremia (within 4 weeks) also had significantly older donors than those with later-onset viremia (difference in age 10.1 years; 95% CI, 2–19; P = .03). Conclusions Older donor age was an independent predictor of viremia and earlier-onset of viremia in D+R− liver transplant recipients. Future studies should assess the mechanistic links underlying this novel association. Clinical Trial Registration NCT01552369. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|