Studies evaluating high-dose acyclovir, intravenous immune globulin, and cytomegalovirus hyperimmunoglobulin for prophylaxis against cytomegalovirus in kidney transplant recipients
| Autor: | Scott A. McCraney, Michael P. Gosland, Benjamin I Dickinson, Mary Lea Gora-Harper |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
medicine.medical_specialty
Pediatrics Congenital cytomegalovirus infection Acyclovir medicine.disease_cause Antiviral Agents Herpesviridae Betaherpesvirinae Epidemiology medicine Humans Pharmacology (medical) Aciclovir Kidney transplantation Clinical Trials as Topic biology business.industry Immune Sera Immunization Passive virus diseases Immunoglobulins Intravenous biology.organism_classification medicine.disease Kidney Transplantation Transplantation Regimen Immunology Cytomegalovirus Infections business medicine.drug |
| Zdroj: | The Annals of pharmacotherapy. 30(12) |
| ISSN: | 1060-0280 |
| Popis: | OBJECTIVE: To describe the epidemiology and pathogenesis of cytomegalovirus (CMV) and critically analyze the studies evaluating the cost, safety, and efficacy of high-dose acyclovir, intravenous immune globulin (IVIG), and CMV hyperimmunoglobulin (CMVIG) for prophylaxis against CMV in kidney transplant recipients. DATA SOURCES: Appropriate articles were identified by searching MEDLINE. Various combinations of the following medical subject heading terms were used: immunoglobulins, intravenous; acyclovir; CMVIG; CMV infections; kidney transplantation; IVIG; and prophylaxis. STUDY SELECTION: Studies evaluating or discussing the cost, safety, and efficacy of IVIG, high-dose acyclovir, and CMVIG in kidney transplant recipients were included. DATA EXTRACTION: The data were evaluated with respect to study design, patient population, prophylactic regimen, incidence of CMV complications, investigators' definitions of terminology, and cost analysis. The studies are summarized in tables and discussed in the text. DATA SYNTHESIS: The definitions of terminology used by the investigators varied widely among studies. The studies were reviewed and discussed using the following definitions: CMV infection was the presence of CMV antibodies in a previously CMV-seronegative patient or a fourfold rise in antibody titer after transplantation; CMV syndrome was CMV infection plus unexplained fever, leukopenia, or thrombocytopenia in the absence of an identifiable cause; and CMV disease was CMV syndrome plus pneumonitis, enteritis, retinitis, hepatitis, or central nervous system involvement. CONCLUSIONS: All regimens appear to effectively reduce the incidence of CMV-associated complications compared with placebo. Due to the lack of trials comparing cost, efficacy, and safety, the most effective prophylactic treatment is unknown. |
| Databáze: | OpenAIRE |
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