Risk factors for cytomegalovirus disease in seropositive renal transplant recipients; a single-center case-controlled study

Abstract

Background: Risk factors for cytomegalovirus (CMV) disease in renal transplant recipients have been evaluated in industrialized countries with relatively low CMV seroprevalence. Objectives: We aimed to determine which factors are related to this illness in a high CMV seroprevalence country. Patients and Methods: A case-control study was performed with data from a 5-year follow-up of 260 kidney transplant recipients at our center. Odds ratios were calculated using the Mantel-Haenszel method. Results: A total of 25 cases of CMV disease occurred during the study period. Recipient age greater than 55 years old (odds ratio: 4.95, 95% CI: 1.44–17.0) and use of thymoglobulin (odds ratio: 4.84; 95% CI: 1.10–21.39) were the only independent predictors for CMV disease. There was not any relationship between the previous serologic status of both donor and receptor and the occurrence of CMV disease. We did not observe any association between the immunosuppressive regimens and CMV disease, except for thymoglobulin. Conclusions: Only recipient age and thymoglobulin administration were related to CMV disease. Further studies are needed to determine if prophylactic treatment confers clinical benefit in this subset of patients.

Incidence and severity of cytomegalovirus infection in seropositive heart transplant recipients

“…Patients who acquire CMV from their transplant donor (donor positive/recipient negative, D+/R‐) are at the highest risk of infection and generally receive 6 months of valganciclovir prophylaxis 17–20 . Recipients who have had an infection with CMV prior to transplantation (R+ HTR) are considered intermediate risk unless they receive antilymphocyte agents such as thymoglobulin for induction or rejection 21–23 . Their risk of CMV is less clear, with estimates in prior studies ranging widely 24–29 .…”

“… 17 , 18 , 19 , 20 Recipients who have had an infection with CMV prior to transplantation (R+ HTR) are considered intermediate risk unless they receive antilymphocyte agents such as thymoglobulin for induction or rejection. 21 , 22 , 23 Their risk of CMV is less clear, with estimates in prior studies ranging widely. 24 , 25 , 26 , 27 , 28 , 29 Practice varies in these patients with many receiving 3‐6 months of prophylaxis but others undergoing virologic monitoring.…”

Current characteristics and outcomes of Cytomegalovirus Reactivation in kidney transplant seropositive recipients in the era of prophylaxis treatment. Lesson from single Moroccan center experience

“…Advanced age was also considered as the main risk factor of development of symptomatic infection [9, 39, 40]. However, in our cohort, we found that the young patients were more likely to have symptomatic viral reactivation (28.75 ± 5.12 vs. 38.09 ± 12.34, p < 0.007).…”

Genotyping clinical cytomegalovirus isolates in solid-organs-transplant recipients

“…Проведенные исследования позволили выявить широкую распространенность цитомегаловирусной инфекции у пациентов, перенесших трансплантацию солидных органов. Так, ДНК ЦМВ была обнаружена у 46,7±3,9% пациентов, перенесших пересадку почки, и у 28,6±3,6% реципиентов печени, что согласуется с данными аналогичных исследований [9,11,16,23]. Следует отметить, что уровень серопозитивности у подавляющего большинства реципиентов солидных органов был достоверно высоким Рисунок 3.…”