Preemptive use of oral ganciclovir to prevent cytomegalovirus infection in liver transplant patients: A randomized, placebo-controlled trial

Carlos V. Paya, Jennie A. Wilson, Mark J. Espy, Irene G. Sia, Michael J. DeBernardi, Thomas F. Smith, Robin Patel, Greg Jenkins, William S. Harmsen, David J. Vanness, Russell H. Wiesner

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116 Scopus citations

Abstract

The use of postdetection antiviral treatment of cytomegalovirus (CMV) as a strategy to prevent infection and disease in solid-organ transplant patients has not been evaluated by placebo-controlled trials. We carried out such a study in 69 patients who had received liver transplants and had positive results of CMV polymerase chain reaction within 8 weeks after transplantation but did not have concomitant CMV infection or disease. These patients were randomly assigned to receive placebo or oral ganciclovir for 8 weeks. CMV infection developed in 21% and disease developed in 12% of placebo recipients (P = .022), compared with 3% and 0%, respectively, among ganciclovir recipients (P = .003). Similarly, in the placebo arm, 55% and 36% of CMV-negative patients who received organs from CMV-positive donors developed CMV infection or disease, respectively (P = .02), compared with 11% and 0% of such patients in the ganciclovir arm (P < .01). Oral ganciclovir administered on CMV detection by PCR prevents CMV infection or disease after liver transplantation.

Original languageEnglish (US)
Pages (from-to)854-860
Number of pages7
JournalJournal of Infectious Diseases
Volume185
Issue number7
DOIs
StatePublished - Apr 1 2002

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ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

Cite this

Paya, C. V., Wilson, J. A., Espy, M. J., Sia, I. G., DeBernardi, M. J., Smith, T. F., Patel, R., Jenkins, G., Harmsen, W. S., Vanness, D. J., & Wiesner, R. H. (2002). Preemptive use of oral ganciclovir to prevent cytomegalovirus infection in liver transplant patients: A randomized, placebo-controlled trial. Journal of Infectious Diseases, 185(7), 854-860. https://doi.org/10.1086/339449