Preventive Strategies Against Cytomegalovirus and Incidence of α-Herpesvirus Infections in Solid Organ Transplant Recipients: A Nationwide Cohort Study.

Details

Serval ID
serval:BIB_19E462B2BC1D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Preventive Strategies Against Cytomegalovirus and Incidence of α-Herpesvirus Infections in Solid Organ Transplant Recipients: A Nationwide Cohort Study.
Journal
American journal of transplantation
Author(s)
Martin-Gandul C., Stampf S., Héquet D., Mueller N.J., Cusini A., van Delden C., Khanna N., Boggian K., Hirzel C., Soccal P., Hirsch H.H., Pascual M., Meylan P., Manuel O.
Working group(s)
Swiss Transplant Cohort Study (STCS)
Contributor(s)
Achermann R., Amico P., Aubert J.D., Baumann P., Beldi G., Benden C., Berger C., Binet I., Bochud P.Y., Boely E., Bucher H., Bühler L., Carell T., Catana E., Chalandon Y., de Geest S., de Rougemont O., Dickenmann M., Duchosal M., Elkrief L., Fehr T., Ferrari-Lacraz S., Garzoni C., Gaudet C., Giostra E., Golshayan D., Hadaya K., Halter J., Heim D., Hess C., Hillinger S., Hofbauer G., Huynh-Do U., Immer F., Klaghofer R., Koller M., Laesser B., Lehmann R., Lovis C., Marti H.P., Yves Martin P., Martinolli L., Mohacsi P., Morel P., Mueller U., Mueller-McKenna H., Müller A., Müller T., Müllhaupt B., Nadal D., Passweg J., Piot Ziegler C., Rick J., Roosnek E., Rosselet A., Rothlin S., Ruschitzka F., Schanz U., Schaub S., Schnyder A., Seiler C., Steiger J., Stirnimann G., Toso C., Venetz J.P., Villard J., Wick M., Wilhelm M., Yerly P.
ISSN
1600-6143 (Electronic)
ISSN-L
1600-6135
Publication state
Published
Issued date
07/2017
Peer-reviewed
Oui
Volume
17
Number
7
Pages
1813-1822
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
We assessed the impact of antiviral preventive strategies on the incidence of herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections in a nationwide cohort of transplant recipients. Risk factors for the development of HSV or VZV infection were assessed by Cox proportional hazards regression. We included 2781 patients (56% kidney, 20% liver, 10% lung, 7.3% heart, 6.7% others). Overall, 1264 (45%) patients received antiviral prophylaxis (ganciclovir or valganciclovir, n = 1145; acyclovir or valacyclovir, n = 138). Incidence of HSV and VZV infections was 28.9 and 12.1 cases, respectively, per 1000 person-years. Incidence of HSV and VZV infections at 1 year after transplant was 4.6% (95% confidence interval [CI] 3.5-5.8) in patients receiving antiviral prophylaxis versus 12.3% (95% CI 10.7-14) in patients without prophylaxis; this was observed particularly for HSV infections (3% [95% CI 2.2-4] versus 9.8% [95% CI 8.4-11.4], respectively). A lower rate of HSV and VZV infections was also seen in donor or recipient cytomegalovirus-positive patients receiving ganciclovir or valganciclovir prophylaxis compared with a preemptive approach. Female sex (hazard ratio [HR] 1.663, p = 0.001), HSV seropositivity (HR 5.198, p < 0.001), previous episodes of rejection (HR 1.95, p = 0.004), and use of a preemptive approach (HR 2.841, p = 0.017) were significantly associated with a higher risk of HSV infection. Although HSV and VZV infections were common after transplantation, antiviral prophylaxis significantly reduced symptomatic HSV infections.
Keywords
Adult, Antiviral Agents/therapeutic use, Cohort Studies, Cytomegalovirus/drug effects, Cytomegalovirus Infections/drug therapy, Cytomegalovirus Infections/epidemiology, Cytomegalovirus Infections/virology, Female, Follow-Up Studies, Graft Rejection/epidemiology, Graft Rejection/prevention & control, Graft Rejection/virology, Graft Survival, Herpesviridae Infections/epidemiology, Herpesviridae Infections/prevention & control, Herpesviridae Infections/virology, Herpesvirus 3, Human/drug effects, Humans, Incidence, Male, Middle Aged, Organ Transplantation/adverse effects, Prognosis, Risk Factors, Switzerland/epidemiology, Transplant Recipients, antibiotic: antiviral-ganciclovir/valganciclovir, clinical research/practice, infection and infectious agents, infectious disease, viral, viral: herpes zoster/Varicella
Pubmed
Web of science
Open Access
Yes
Create date
10/01/2017 19:29
Last modification date
20/08/2019 13:51
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