Determinants of protracted cytomegalovirus infection in solid-organ transplant patients

Détails

ID Serval
serval:BIB_BFC1CA3D1390
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Determinants of protracted cytomegalovirus infection in solid-organ transplant patients
Périodique
Transplantation
Auteur⸱e⸱s
Muheim  C., Vogel  G., Seydoux  C., Gillet  M., Mosimann  F., Von Segesser  L., Sahli  R., Estrade  C., van Melle  G., Meylan  P. R.
ISSN
0041-1337 (Print)
Statut éditorial
Publié
Date de publication
07/2002
Volume
74
Numéro
2
Pages
226-36
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jul 27
Résumé
BACKGROUND: Recurrent infection frequently follows the response to the initial treatment of cytomegalovirus (CMV) infection in solid-organ transplant (SOT) recipients. The objective of this study was to describe the course of CMV infection in SOT patients and to identify factors that would predict protracted CMV infection with recurrences. METHODS: Quantitative polymerase chain reaction (PCR) assay for CMV DNA in leukocytes and in plasma were used to assess viral load changes retrospectively in consecutive SOT patients, whose CMV infection episodes had been attended therapeutically or preemptively using quantitative blood culture. RESULTS: Among 101 SOT patients, CMV infection occurred in 63, of whom 32 developed recurrent infection after the initial episode. In patients with recurrent infection, PCR indicated that a majority (27) of recipients had high level of CMV DNA in peripheral blood leukocytes and plasma throughout a protracted (>/=1 month) period including after preemptive or therapeutic ganciclovir courses. Predictors of protracted high-level infection were increasing age, CMV donor seropositivity, and all measures of viral load during the initial episode. CMV recipient seropositivity protected strongly against protracted infection. End of treatment plasma CMV DNA best discriminated between patients who did or did not develop protracted infection. CONCLUSIONS: In SOT patients, protracted CMV infection is associated with increasing age, donor seropositivity, recipient seronegativity, and high viral load during the first episode. End of therapy plasma CMV DNA level best predicts the occurrence of protracted infection. In patients with a high risk of protracted infection, prophylaxis is likely to be particularly cost effective.
Mots-clé
Adult Aged Cytomegalovirus Infections/epidemiology/*etiology/virology Female Humans Incidence Logistic Models Male Middle Aged Organ Transplantation/*adverse effects Polymerase Chain Reaction Risk Factors Viral Load
Pubmed
Web of science
Open Access
Oui
Création de la notice
28/01/2008 10:11
Dernière modification de la notice
20/08/2019 15:34
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