Impact of antiviral preventive strategies on the incidence and outcomes of cytomegalovirus disease in solid organ transplant recipients.

Details

Serval ID
serval:BIB_CEF33B24BED3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact of antiviral preventive strategies on the incidence and outcomes of cytomegalovirus disease in solid organ transplant recipients.
Journal
American Journal of Transplantation
Author(s)
Manuel O., Kralidis G., Mueller N.J., Hirsch H.H., Garzoni C., van Delden C., Berger C., Boggian K., Cusini A., Koller M.T., Weisser M., Pascual M., Meylan P.R.
Working group(s)
Swiss Transplant Cohort Study
ISSN
1600-6143 (Electronic)
ISSN-L
1600-6135
Publication state
Published
Issued date
2013
Volume
13
Number
9
Pages
2402-2410
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
We assessed the impact of antiviral prophylaxis and preemptive therapy on the incidence and outcomes of cytomegalovirus (CMV) disease in a nationwide prospective cohort of solid organ transplant recipients. Risk factors associated with CMV disease and graft failure-free survival were analyzed using Cox regression models. One thousand two hundred thirty-nine patients transplanted from May 2008 until March 2011 were included; 466 (38%) patients received CMV prophylaxis and 522 (42%) patients were managed preemptively. Overall incidence of CMV disease was 6.05% and was linked to CMV serostatus (D+/R- vs. R+, hazard ratio [HR] 5.36 [95% CI 3.14-9.14], pâeuro0/00<âeuro0/000.001). No difference in the incidence of CMV disease was observed in patients receiving antiviral prophylaxis as compared to the preemptive approach (HR 1.16 [95% CI 0.63-2.17], pâeuro0/00=âeuro0/000.63). CMV disease was not associated with a lower graft failure-free survival (HR 1.27 [95% CI 0.64-2.53], pâeuro0/00=âeuro0/000.50). Nevertheless, patients followed by the preemptive approach had an inferior graft failure-free survival after a median of 1.05 years of follow-up (HR 1.63 [95% CI 1.01-2.64], pâeuro0/00=âeuro0/000.044). The incidence of CMV disease in this cohort was low and not influenced by the preventive strategy used. However, patients on CMV prophylaxis were more likely to be free from graft failure.
Pubmed
Web of science
Open Access
Yes
Create date
20/09/2013 18:21
Last modification date
20/08/2019 16:49
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