Efficacy of low-dose valganciclovir in CMV R+ lung transplant recipients: a retrospective comparative analysis
| Autor: | Rajat Walia, Jessica Hunt, Lauren Cherrier, Aasya Nasar, Kristina Chapple |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment Congenital cytomegalovirus infection valganciclovir Cytomegalovirus Viremia 030230 surgery Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine lung transplantation Lung transplantation Clinical significance Original Research Article Prospective cohort study Adverse effect business.industry Incidence (epidemiology) virus diseases Valganciclovir medicine.disease 030211 gastroenterology & hepatology business medicine.drug |
| Zdroj: | Multidisciplinary Respiratory Medicine |
| ISSN: | 1828-695X |
| Popis: | Background: Cytomegalovirus (CMV) infection is extremely common after lung transplant and can be associated with significant morbidity and mortality. Current practice suggests the use of 900 mg daily of valganciclovir for CMV prophylaxis, but there is no literature assessing whether 450 mg daily of valganciclovir is sufficient in intermediate CMV risk lung transplant recipients. Therefore, we sought to assess the role of low-dose valganciclovir (LDV) versus high-dose valganciclovir (HDV) prophylaxis in intermediate-risk (R+) recipients.Methods: We conducted a retrospective analysis on lung transplant recipients at the Norton Thoracic Institute in Phoenix, Arizona looking at intermediate-risk patients that received either valganciclovir 450 mg per day (LDV) or 900 mg/day (HDV). All patients were followed for 1 year posttransplant for incidence of CMV viremia. The primary outcome was the rate of CMV viremia as determined by a positive CMV polymerase chain reaction ([PCR] >2.7 log copies/mL). Secondary outcomes included rate of adverse events, acute cellular rejection, and mortality.Results: The primary analysis included 103 patients (55 in the LDV group, 48 in the HDV group). In the LDV group, 9 patients (16.4%) developed CMV viremia compared to 4 (8.3%) in the HDV group (p=0.221) with no difference observed in adverse event rates between groups.Conclusion: There was no statistical difference between groups for the primary outcome. However, the effect size demonstrated in this analysis may be of clinical relevance and valganciclovir 450 mg daily would not be recommended in intermediate risk lung transplant recipients at this time. To confirm our results, further prospective studies enrolling larger patient populations are necessary. |
| Databáze: | OpenAIRE |
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