Two-year post-transplantation cytomegalovirus DNAemia in asymptomatic kidney transplant recipients: incidence, risk factors, and outcome.
Transpl Infect Dis
; 17(4): 497-509, 2015 Aug.
Article
em En
| MEDLINE
| ID: mdl-26052675
ABSTRACT
BACKGROUND:
The incidence and the impact of asymptomatic cytomegalovirus (CMV) DNAemia occurring after the first year post transplantation is unknown.METHODS:
In this retrospective cross-sectional study, we analyzed the incidence, risk factors, and impact of 2-year post-transplantation asymptomatic CMV DNAemia (2YCD) on graft function. We included 892 consecutive asymptomatic kidney transplant recipients transplanted for at least 2 years and all were monitored using whole blood CMV quantitative nucleic acid amplification testing (CMV-QNAT).RESULTS:
Twenty-eight patients displayed 2YCD (3.1%). Using multivariate analysis in 578 patients, we found that female gender (odds ratio [OR] = 2.57, P = 0.02), a past history of CMV drug-resistance mutation (OR = 8.73, P = 0.005), and corticosteroid use (OR = 2.37, P = 0.03) were independently associated with an increased risk of 2YCD. 2YCD was associated with an increased incidence of subsequent CMV disease over the year following its diagnosis (7% vs. 0.6%, P = 0.02). Patients with 2YCD also exhibited a declining estimated glomerular filtration rate more frequently (77%) than patients with a negative CMV-QNAT (56%, P = 0.02).CONCLUSION:
2YCD appears to be a rare entity, which appears to be associated with chronic graft dysfunction.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Transplante de Rim
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Infecções por Citomegalovirus
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Citomegalovirus
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Infecções Assintomáticas
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article