Allograft rejection predicts the occurrence of late-onset cytomegalovirus (CMV) disease among CMV-mismatched solid organ transplant patients receiving prophylaxis with oral ganciclovir

Raymund R. Razonable, Antonio Rivero, Aurelio Rodriguez, Jennie Wilson, Judith Daniels, Gregory Jenkins, Timothy Larson, Walter C. Hellinger, James R. Spivey, Carlos V. Paya

Research output: Contribution to journalArticle

182 Scopus citations

Abstract

The natural history of cytomegalovirus (CMV) disease associated with solid organ transplantation has been modified as a result of the widespread use of antiviral prophylaxis. Anecdotal reports have indicated a reduction of CMV disease at the expense of its later occurrence after completion of ganciclovir prophylaxis. The present study investigated the occurrence of CMV disease and its risk factors among 37 liver and kidney transplant recipients with CMV D+/Rstatus who received oral ganciclovir during the first 100 days posttransplantation. CMV disease occurred in 9 patients (24.3%) at a median of 144 days posttransplantation (range, 95-190 days). Allograft rejection was found to be strongly associated with the occurrence of late-onset CMV disease (risk ratio, 6.6; 95% confidence interval, 1.4-32.1; P = .02). Thus, CMV D+/R- solid organ transplant recipients receiving 3 months of oral ganciclovir who develop allograft rejection during the period of antiviral prophylaxis may benefit from extended and/or enhanced antiviral prophylaxis to prevent late-onset CMV disease.

Original languageEnglish (US)
Pages (from-to)1461-1464
Number of pages4
JournalJournal of Infectious Diseases
Volume184
Issue number11
DOIs
StatePublished - Dec 1 2001

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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