Valganciclovir prophylaxis delays onset of EBV viremia in high-risk pediatric solid organ transplant recipients
| Autor: | Atul Sharma, Alissa J. Wright, Sawsan Albatati, Soren Gantt, Tom Blydt-Hansen, Kathryn Haubrich |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Epstein-Barr Virus Infections medicine.medical_specialty Adolescent Viremia Antiviral Agents Gastroenterology Disease-Free Survival Virus 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases 030225 pediatrics Internal medicine medicine Humans Valganciclovir Child Survival analysis Proportional Hazards Models Retrospective Studies Immunosuppression Therapy business.industry Graft Survival Confounding Retrospective cohort study Organ Transplantation medicine.disease Transplant Recipients Transplantation Multivariate Analysis Pediatrics Perinatology and Child Health Cohort Female business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Pediatric Research. 87:892-896 |
| ISSN: | 1530-0447 0031-3998 |
| DOI: | 10.1038/s41390-019-0523-4 |
| Popis: | BACKGROUND The role of antiviral prophylaxis to prevent Epstein-Barr virus (EBV) viremia or posttransplant lymphoproliferative disorder in pediatric solid organ transplant recipients is controversial. We examined whether valganciclovir (VAL) prophylaxis for cytomegalovirus infection was associated with EBV viremia following transplantation in EBV-naive children. METHODS A single-center, retrospective study was conducted of EBV-naive pediatric heart and renal transplant recipients with an EBV-positive donor from January 1996 to April 2017. VAL was tested for association with EBV viremia-free survival in the first 6 months posttransplantation when immunosuppressant exposure is the highest. Survival models evaluated VAL duration, with adjustment for other baseline confounders. RESULTS Among the cohort (n = 44), 3 (6.8%) were heart transplants, 25 (56.8%) received VAL, and 22 (50%) developed EBV viremia in the first-year posttransplantation. Mean time-to-viremia was 143 vs. 90 days for the VAL and no-VAL groups, respectively (p = 0.008), in the first 6 months. Only two patients developed viremia while on VAL. Each additional day of VAL was associated with 1.4% increase in viremia-free survival (p |
| Databáze: | OpenAIRE |
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