TY - JOUR
T1 - Allograft rejection predicts the occurrence of late-onset cytomegalovirus (CMV) disease among CMV-mismatched solid organ transplant patients receiving prophylaxis with oral ganciclovir
AU - Razonable, Raymund R.
AU - Rivero, Antonio
AU - Rodriguez, Aurelio
AU - Wilson, Jennie
AU - Daniels, Judith
AU - Jenkins, Gregory
AU - Larson, Timothy
AU - Hellinger, Walter C.
AU - Spivey, James R.
AU - Paya, Carlos V.
PY - 2001/12/1
Y1 - 2001/12/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0035576910&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0035576910&partnerID=8YFLogxK
U2 - 10.1086/324516
DO - 10.1086/324516
M3 - Article
C2 - 11709790
AN - SCOPUS:0035576910
SN - 0022-1899
VL - 184
SP - 1461
EP - 1464
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 11
ER -