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

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.

• Authors: Nina Singh, Drew J Winston, Raymund R Razonable, G Marshall Lyon, Fernanda P Silveira, Marilyn M Wagener, Ajit P Limaye
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 223 Issue 6 Pg. 1073-1077 (03 29 2021) ISSN: 1537-6613 [Electronic] United States
• PMID: 32726431 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Chemical References

• Antiviral Agents
• Ganciclovir

Topics

• Age Factors
• Antiviral Agents (therapeutic use)
• Cytomegalovirus
• Cytomegalovirus Infections (drug therapy)
• Ganciclovir (therapeutic use)
• Humans
• Liver Transplantation
• Risk Factors
• Tissue Donors
• Viremia (drug therapy)