Valganciclovir Preemptive Therapy for the Prevention of Cytomegalovirus Disease in High-Risk Seropositive Solid-Organ Transplant Recipients

Díaz-Pedroche, Carmen; Lumbreras, Carlos; Juan, Rafael San; Folgueira, Lola; Andrés, Amado; Delgado, Juan; Meneu, J.C.; Morales, José; Moreno-Elola, A.; Hernando, Susana; Moreno‐González, E.; Aguado, José María

doi:10.1097/01.tp.0000225830.76907.d0

Cited by 46 publications

(25 citation statements)

References 36 publications

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“…Six of the nine studies described explicitly the relationship between preemptive therapy and subsequent development of CMV disease (22,23,27,30,31,33,34) (22,23,26,27,(29)(30)(31)(32)(33). Five studies reported subsequent follow-up for 39 patients with recurrence after preemptive valganciclovir use for their first episodes of viremia (23,27,(30)(31)(32). Two patients developed CMV disease (27) (27).…”

Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

“…CMV disease developed in 15.5% (17/110) of the patients receiving these agents and 0% (0/187) of those not receiving (23,28). (30,31). Similarly, the threshold of DNAemia by CMV DNA PCR to initiate preemptive treatment varied from ≥15 to ≥2000 copies/mL (23,(27)(28)(29)(32)(33)(34).…”

Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

“…The follow-up duration was a minimum of 12 months after transplantation in all but three studies (29,30,33 (27,28,32). Exclusion of a study (28) (27,28,32 (27,28,(30)(31)(32). Only two studies explicitly reported receipts of T-cell-depleting agents (23,28).…”

Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

“…(18,19). However, existing studies have primarily comprised small sample sizes and previous meta-analyses have excluded valganciclovir (1,2,20,21 (22,23,(26)(27)(28)(29)(30)(31)(32)(33)(34) (Table 1). The follow-up duration was a minimum of 12 months after transplantation in all but three studies (29,30,33 (27,28,32).…”

Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

“…Similarly, the threshold of DNAemia by CMV DNA PCR to initiate preemptive treatment varied from ≥15 to ≥2000 copies/mL (23,(27)(28)(29)(32)(33)(34). In all, three studies monitored for antigenemia or DNAemia for 3 months, 2 for 6 months, 2 for 12 months, and 1 for 4 months posttransplant (22,23,(26)(27)(28)(29)(30)(31)(32) (22,23,(27)(28)(29)(30)(31)(32)(33)(34). Six of the nine studies described explicitly the relationship between preemptive therapy and subsequent development of CMV disease (22,23,27,30,31,33,34) (22,23,26,27,(29)(30)(31)(32)(33).…”

Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

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Prevention of Posttransplant Cytomegalovirus Disease and Related Outcomes with Valganciclovir: A Systematic Review

Sun

Wagener

Singh

2008

American Journal of Transplantation

108

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The precise impact of valganciclovir as preventive therapy for cytomegalovirus (CMV) in solid organ transplant (SOT) recipients is not fully defined. Data from studies using valganciclovir as preemptive therapy or prophylaxis for CMV in SOT recipients were synthesized for descriptive analysis. CMV disease occurred in 2.6% and 9.9% of the patients receiving valganciclovir as preemptive therapy and prophylaxis, respectively. Although the incidence of early-onset (≤90 days posttransplant) CMV disease was only 0.8% and 1.2% in all patients and R-/D+ patients receiving valganciclovir prophylaxis, the incidence of late-onset (>90 days posttransplant) CMV disease rose up to 8.9% and 17.7% in the prophylactic group, respectively. On the contrary, no patients developed late-onset CMV disease in preemptive group. Both approaches with valganciclovir have successfully decreased CMV disease in SOT recipients. Late-onset CMV disease is a complication observed uniquely with valganciclovir prophylaxis, particularly in R-/D+ patients, but not with preemptive therapy.

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Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

Section: Cytomegalovirus (Cmv) Is An Important Opportunistic Pathogenmentioning

confidence: 99%

See 3 more Smart Citations

Prevention of Posttransplant Cytomegalovirus Disease and Related Outcomes with Valganciclovir: A Systematic Review

Sun

Wagener

Singh

2008

American Journal of Transplantation

108

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Cytomegaloviruses

Livingston¹,

Chatterjee²,

Harrison³

2007

Encyclopedia of Life Sciences

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Cytomegaloviruses

Chatterjee¹,

Livingston²,

Harrison³

2011

Encyclopedia of Life Sciences

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The cytomegaloviruses are a common, ancient group of viruses that are widely distributed in the animal kingdom. They have a complex biology with a highly restricted host range. These viruses spread easily in the human population, causing mostly asymptomatic infection. This large reservoir of latent infection however, is a significant threat to high‐risk patients including immunocompromised hosts and the fetus in nonimmune pregnant mothers. Although a limited number of antiviral agents for treatment and prophylaxis in selected patient groups, as well as other adjunctive therapies have become available over the past few decades, newer, less toxic medications and a safe and effective vaccine remain in the research realm. Other areas still to be investigated include identification of the site of viral latency, characterisation of the targets of acute infection, determination of the exact role of virus and host immune response in disease and latency. Key Concepts: The cytomegaloviruses (CMVs) belong to the family of deoxyribonucleic acid (DNA) viruses known as Herpesviridae . CMVs have complex biology and are widely distributed in nature, yet each animal species has its own CMV. The prevalence of human CMV infection varies with age, geographic location, cultural and socioeconomic status, race or ethnicity and child‐rearing practices. In most cases, human CMV infection in normal hosts is asymptomatic, but it can cause a mononucleosis syndrome similar to that from Epstein–Barr Virus ( EBv ) infection. The greatest risk from CMV is in immunocompromised patients and infants born to nonimmune mothers who develop primary infection during their pregnancy. CMV has been one of the most important opportunistic infections in patients with AIDS. Antiviral agents used to treat severe CMV disease include ganciclovir, valganciclovir, foscarnet, cidofovir and fomivirsen. Passive immunoprophylaxis with CMV hyperimmunoglobulin (CMVIG) in post‐transplant patients, premature newborns at risk for postnatal infection and pregnant women is controversial. Blood/organ donor screening, ‘leucocyte‐reduction’ in donated blood, handwashing and other hygienic measures can reduce the spread of CMV. Newer therapeutic agents and a vaccine are under development.

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Valganciclovir Preemptive Therapy for the Prevention of Cytomegalovirus Disease in High-Risk Seropositive Solid-Organ Transplant Recipients

Abstract: VGCV is safe and highly efficacious in the prevention of CMV disease in high-risk seropositive organ transplant recipients.

Cited by 46 publications

References 36 publications

Prevention of Posttransplant Cytomegalovirus Disease and Related Outcomes with Valganciclovir: A Systematic Review

Prevention of Posttransplant Cytomegalovirus Disease and Related Outcomes with Valganciclovir: A Systematic Review

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