Risk Factors for Cytomegalovirus Viremia following Liver Transplantation With a Seropositive Donor and Seronegative Recipient Receiving Antiviral Therapy

Nina Singh, Drew J. Winston, Raymund R. Razonable, G. Marshall Lyon, Fernanda P. Silveira, Marilyn M. Wagener, Ajit P. Limaye

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The risk factors for development of viremia in high-risk donor cytomegalovirus (CMV)-seropositive and recipient CMV-seronegative (D+R-) transplant recipients are incompletely defined. METHODS: The study population comprised patients in the preemptive therapy (PET) arm of a randomized, controlled trial of PET versus prophylaxis using valganciclovir in D+R- liver transplant recipients. Weekly surveillance monitoring for viremia for 100 days was performed using a sensitive CMV-DNA polymerase chain reaction assays. Risk factors for viremia and time to onset (≤4 vs >4 weeks) of viremia were examined using logistic regression models. RESULTS: Viremia developed in 84% (79/94) of recipients and older donor age was the only independent factor associated with viremia (odds ratio, 2.20 for each quartile increase in donor age; 95% confidence interval [CI], 1.07-4.52; P = .031). Recipients who developed early-onset viremia (within 4 weeks) also had significantly older donors than those with later-onset viremia (difference in age 10.1 years; 95% CI, 2-19; P = .03). CONCLUSIONS: Older donor age was an independent predictor of viremia and earlier-onset of viremia in D+R- liver transplant recipients. Future studies should assess the mechanistic links underlying this novel association. CLINICAL TRIAL REGISTRATION: NCT01552369.

Original languageEnglish (US)
Pages (from-to)1073-1077
Number of pages5
JournalThe Journal of infectious diseases
Volume223
Issue number6
DOIs
StatePublished - Mar 29 2021

Keywords

  • cytomegalovirus
  • primary CMV infection
  • transplant
  • viremia

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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