Cytomegalovirus infection after acute rejection therapy in seropositive kidney transplant recipients.
Transpl Infect Dis
; 16(3): 397-402, 2014 Jun.
Article
in En
| MEDLINE
| ID: mdl-24810355
ABSTRACT
BACKGROUND:
Acute rejection (AR) after solid organ transplantation has been known to be a risk factor for cytomegalovirus (CMV) infection. However, data regarding the risk for CMV infection during and after anti-rejection therapy are limited. This study investigated whether the risk of CMV infection and disease within 6 months of kidney transplantation (KT) increases in CMV-seropositive KT recipients who develop AR.METHODS:
A total of 992 seropositive KT recipients, including 75 patients (8%) who developed AR within 6 months after KT and 917 patients (92%) who did not, were recruited between May 2007 and April 2012.RESULTS:
No significant difference was found in the incidence of CMV infection between the groups (AR group, 13% [10/75] vs. non-AR group, 10% [92/917], P = 0.37). The number of KT recipients in each group receiving preemptive therapy for CMV was similar (5% [4/75] vs. 6% [53/917], P > 0.99). While the incidence of CMV syndrome was comparable (0% [0/75] vs. 1% [12/917], P > 0.99), the incidence of tissue-invasive CMV disease (8% [6/75] vs. 3% [27/917], P = 0.04), particularly gastrointestinal CMV disease, was significantly greater in patients who experienced AR. No CMV-related mortality occurred in either group. AR (odds ratio, 2.81; 95% confidence interval, 1.08-7.29; P = 0.03) was an independent risk factor for tissue-invasive CMV disease within 6 months of KT.CONCLUSIONS:
A high index of suspicion and active evaluation for tissue-invasive CMV disease in KT recipients suffering AR may be necessary to ensure appropriate treatment.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Kidney Transplantation
/
Cytomegalovirus Infections
/
Cytomegalovirus
/
Graft Rejection
/
Immunosuppressive Agents
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Transpl Infect Dis
Journal subject:
TRANSPLANTE
Year:
2014
Type:
Article