Cytomegalovirus reactivation and disease amongst patients with allogeneic haematopoietic stem cell transplantation in Eastern India: Epidemiology, outcome and healthcare cost.
Indian J Med Microbiol
; 36(1): 49-53, 2018.
Article
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| MEDLINE
| ID: mdl-29735826
ABSTRACT
PURPOSE:
Data from developing countries about incidence, prognosis and healthcare cost of cytomegalovirus (CMV) reactivation amongst patients with allogeneic hematopoietic stem cell transplantation (AHSCT) remain scarce. The purpose of the study was to describe the epidemiology, outcome and cost implications of CMV reactivation and CMV disease amongst patients with AHSCT in cancer hospital in Eastern India. MATERIALS ANDMETHODS:
The study design was a retrospective audit of clinical records.RESULTS:
Ninety-nine per cent of patients and 94% of the donors were found to be CMV seropositive. CMV reactivation rate was 43.8% amongst patients with AHSCT (n = 130 patients). CMV reactivation occurred 118 days after AHSCT (median; range 28-943 days). Patients with any grade of graft-versus-host disease (GVHD) had higher CMV reactivation rate than patients without GVHD. Patients with CMV reactivation had more frequent GVHD than patients without CMV reactivation. Use of steroids was associated with CMV reactivation. We found no differences in overall survival of patients with or without CMV reactivation. The cost of in-house CMV-polymerase chain reaction at our centre was USD $57 (Rs. 3650), cost for intravenous ganciclovir was USD $26 (Rs. 1665) per infusion and oral valganciclovir USD $8 (Rs. 512)/900 mg tablet. The median duration of anti-CMV therapy was 14 days (interquartile range 14-28 days) and the average cost per patient per month directed towards CMV management ranged between USD $800 and USD $1,300 (Rs. 51,238-Rs. 83,264). Three patients (2.3%) in this series had CMV disease, all of whom died.CONCLUSION:
In an increasingly globalised world, where medical tourism is common, data from developing countries regarding cost and outcome of CMV infections in AHSCT patients are of relevance.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Antivirales
/
Ganciclovir
/
Costos de la Atención en Salud
/
Infecciones por Citomegalovirus
/
Trasplante de Células Madre Hematopoyéticas
Tipo de estudio:
Health_economic_evaluation
/
Observational_studies
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Risk_factors_studies
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Screening_studies
País/Región como asunto:
Asia
Idioma:
En
Revista:
Indian J Med Microbiol
Asunto de la revista:
MICROBIOLOGIA
Año:
2018
Tipo del documento:
Article