Treatment of Cytomegalovirus Disease with Valganciclovir in Renal Transplant Recipients: A Single Center Experience

Babel, Nina; Gabdrakhmanova, L. A.; Juergensen, J. S.; Eibl, Nermin; Hoerstrup, J.; Hammer, Markus; Rosenberger, Christian; Hoeflich, Conny; Frei, Ulrich; Rohde, Frank; Volk, Hans‐Dieter; Reinke, Petra

doi:10.1097/01.tp.0000128343.88355.14

Cited by 32 publications

(20 citation statements)

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“…Our data showed that the proportion of CMV-positive donors and CMV-negative recipients was greater for episodes that experienced relapse (14.3%) than for those that experienced success (9.6%), although the difference was not statistically significant. Again, a previous study of valganciclovir as preemptive therapy reported a recurrence rate similar to ours [10]. In that study, CMV disease occurred mainly in the late posttransplantation period, and many cases were likely to have been late reactivations of infection, which are associated with a lower risk of recurrence [10].…”

Section: Discussionmentioning

confidence: 48%

“…The reported data in the literature regarding such patients are very sparse and quite limited but point in the direction of our findings [10][11][12][13][14][15][16][17]. In various populations, involving a small number of patients and no comparison groups, including renal [10], cardiac [11,12], lung [12,15], and liver [17] transplant recipients, valganciclovir seemed to be effective and safe as either preemptive therapy or treatment for viral syndrome. It has been also reported that valganciclovir reduces the CMV DNA level in a manner similar to that of intravenous ganciclovir when given as part of a preemptive strategy [13,16].…”

Section: Discussionmentioning

confidence: 80%

“…It is plausible that the higher bioavailability of valganciclovir will make it useful for treating symptomatic CMV infection as well. Preliminary studies with a small number of patients have offered promising (but limited) information on the value of this drug in SOT recipients [10][11][12][13][14][15][16][17].…”

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confidence: 99%

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Valganciclovir as Treatment for Cytomegalovirus Disease in Solid Organ Transplant Recipients

Len

Gavaldá

Aguado

et al. 2008

Clinical Infectious Diseases

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Background. Cytomegalovirus (CMV) infection causes morbidity in solid organ transplant (SOT) recipients, either by direct injury or in association with chronic allograft rejection or other opportunistic infections. Ganciclovir is the treatment of choice, but this agent requires intravenous administration, which affects its feasibility for longterm use. Valganciclovir, which has an oral bioavailability of 60%, has proven to be useful for prophylaxis of CMV infection in high-risk SOT recipients and for treating retinitis in persons with acquired immunodeficiency syndrome.Objective. To compare the efficacy of valganciclovir (alone or as sequential therapy after a regimen of intravenous ganciclovir) with intravenous ganciclovir alone for preemptive therapy or treatment of CMV disease (viral syndrome or focal disease) in SOT recipients and to determine the incidence of adverse effects and relapses.Methods. In this 2-year prospective, comparative cohort study, 376 episodes of preemptive therapy or treatment of CMV disease were recorded among 334 of 3467 SOT recipients included in the Spanish Network for Research on Infection in Transplantation (RESITRA) database. Intravenous ganciclovir was the first-line treatment in 170 episodes; valganciclovir followed by intravenous ganciclovir was administered in 82 episodes, and valganciclovir alone was administered in 112 episodes.Results. Valganciclovir was used as preemptive therapy or treatment for CMV disease in 84 and 28 episodes, respectively. Duration of treatment was longer in valganciclovir recipients than in ganciclovir recipients for both preemptive therapy (21 vs. 15 days;) or viral syndrome treatment (21 vs. 18 days; ). In the val-P ! .001 P ! .01 ganciclovir arm, 94 (83.9%) of 112 episodes were treated successfully, with no statistical difference in the success rates versus the ganciclovir arm (85.8%) or ganciclovir-valganciclovir arm (95.1%). Eighteen episodes (16.1%) treated with valganciclovir were considered to have resulted in treatment failure (because of persistent antigenemia in 4 [3.6%], on the basis of clinical decision in 7 [6.2%], and because of recurrent disease in 7 [6.2%]). There were no incidents in which valganciclovir treatment was withdrawn because of toxicity.Conclusion. Valganciclovir is safe and useful for preemptive therapy and treatment of CMV disease.

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 80%

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Valganciclovir as Treatment for Cytomegalovirus Disease in Solid Organ Transplant Recipients

Len

Gavaldá

Aguado

et al. 2008

Clinical Infectious Diseases

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“…TGF-b1 g.869T > C polymorphism was observed to provide risk towards DN in Mexican (Valladares-salgado et al, 2010) and Chinese populations (Wong et al, 2003) and towards ESRD in a North Indian population (Mittal and Manchanda, 2007). Contrarily, reports on German and Spanish populations concluded that 869T allele rather than C allele was associated with ESRD susceptibility (Babel et al, 2006;Coll et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Association of Transforming Growth Factor Beta-1 (TGF-β1) Genetic Variation with Type 2 Diabetes and End Stage Renal Disease in Two Large Population Samples from North India

Raina

Sikka

Kaur

et al. 2015

OMICS: A Journal of Integrative Biology

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Geographic and ethnic differences impart an immense influence on the genetic susceptibility to Type 2 diabetes (T2D) and diabetic nephropathy (DN). Transforming growth factor-beta1 (TGF-b1), a ubiquitously expressed pro-fibrotic cytokine plays a pivotal role in mediating the hypertrophic and fibrotic manifestations of DN. The present study is aimed to study the association of TGF-b1 g.869T > C (rs1800470) and g.-509C > T (rs1800469) polymorphism in T2D and end stage renal disease (ESRD) cases from the two geographically and ethnically different populations from North India. A total of 1313 samples comprising 776 samples from Punjab (204 with ESRD, 257 without ESRD, and 315 healthy controls) and 537 samples from Jammu and Kashmir (150 with ESRD, 187 without ESRD, and 200 controls) were genotyped for TGF-b1 (rs1800470 and rs1800469) using ARMS-PCR. The CC genotype of rs1800470 increased ESRD risk by 3.1-4.5-fold in both populations. However, for rs1800469, the TT genotype provided 5.5-fold risk towards ESRD cases from Jammu and Kashmir and no risk for the cases from Punjab. The haplotype C-T conferred nearly a 2-3-fold risk towards T2D and ESRD and diplotype CC-CT conferred a 4-fold risk towards ESRD. Our results conclude that TGF-b1 (rs1800470) may increase the risk of both ESRD and T2D in both populations, but TGF-b1 (rs1800469) provided risk for only ESRD in the population of Jammu and Kashmir. The present study is one of the large sample sized genetic association studies of T2D and ESRD from Indian population and adds to the scholarship on global health omics.

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“…Si bien no existen estudios clínicos aleatorios publicados, en pacientes con trasplante renal y enfermedad por CMV el tratamiento con valganciclovir hasta la resolución de la antigenemia fue satisfactorio y no se siguió de recidiva 101 . Una dosis de 900 mg es equiparable (área bajo la curva) a una dosis de 5 mg/kg de ganciclovir intravenoso.…”

Section: Tratamiento De La Enfermedad Por CMVunclassified

Infecciones más comunes en el paciente trasplantado

Yuste

Pozo

Quetglas

et al. 2006

Anales Sis San Navarra

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Organ transplantation has become one of the most important areas of medical research and, at present, is still the only therapeutical tool for several diseases. However, there are a number of factors related to transplantation, like immunosuppression and prolonged neutropenia that affect the incidence of infection. These infections are somehow peculiar to trasplant recipients. In fact, there are infectious diseases that only occur in immunodepression situations and, moreover, clinical expression of these infectious diseases can be quite different from that in immunocompetent patients. Besides these aspects, some infections, due to the high prevalence described, must be considered for prevention strategies because they continue to be a principal cause of morbidity and mortality, either due to direct effects or to their implication in the pathogenesis of rejection. These strategies commence before trasplantation by active immunization through vaccine administration to the patient and to people in the milieu and continue after trasplantation with prophylaxis or pre-emptive therapy. The importance of infectious diseases in the evolution and prognosis of trasplant recipients gives a special meaning to the understanding of associated infections, their clinical expression and ways of prevention and treatment.

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Treatment of Cytomegalovirus Disease with Valganciclovir in Renal Transplant Recipients: A Single Center Experience

Cited by 32 publications

References 10 publications

Valganciclovir as Treatment for Cytomegalovirus Disease in Solid Organ Transplant Recipients

Valganciclovir as Treatment for Cytomegalovirus Disease in Solid Organ Transplant Recipients

Association of Transforming Growth Factor Beta-1 (TGF-β1) Genetic Variation with Type 2 Diabetes and End Stage Renal Disease in Two Large Population Samples from North India

Infecciones más comunes en el paciente trasplantado

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