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- Title
Risk Factors for Cytomegalovirus Viremia following Liver Transplantation With a Seropositive Donor and Seronegative Recipient Receiving Antiviral Therapy.
- Authors
Singh, Nina; Winston, Drew J; Razonable, Raymund R; Lyon, G Marshall; Silveira, Fernanda P; Wagener, Marilyn M; Limaye, Ajit P
- Abstract
<bold>Background: </bold>The risk factors for development of viremia in high-risk donor cytomegalovirus (CMV)-seropositive and recipient CMV-seronegative (D+R-) transplant recipients are incompletely defined.<bold>Methods: </bold>The study population comprised patients in the preemptive therapy (PET) arm of a randomized, controlled trial of PET versus prophylaxis using valganciclovir in D+R- liver transplant recipients. Weekly surveillance monitoring for viremia for 100 days was performed using a sensitive CMV-DNA polymerase chain reaction assays. Risk factors for viremia and time to onset (≤4 vs >4 weeks) of viremia were examined using logistic regression models.<bold>Results: </bold>Viremia developed in 84% (79/94) of recipients and older donor age was the only independent factor associated with viremia (odds ratio, 2.20 for each quartile increase in donor age; 95% confidence interval [CI], 1.07-4.52; P = .031). Recipients who developed early-onset viremia (within 4 weeks) also had significantly older donors than those with later-onset viremia (difference in age 10.1 years; 95% CI, 2-19; P = .03).<bold>Conclusions: </bold>Older donor age was an independent predictor of viremia and earlier-onset of viremia in D+R- liver transplant recipients. Future studies should assess the mechanistic links underlying this novel association.<bold>Clinical Trial Registration: </bold>NCT01552369.
- Subjects
LIVER transplantation; CLINICAL trial registries; VIREMIA; CYTOMEGALOVIRUSES; BK virus; POLYMERASE chain reaction
- Publication
Journal of Infectious Diseases, 2021, Vol 223, Issue 6, p1073
- ISSN
0022-1899
- Publication type
journal article
- DOI
10.1093/infdis/jiaa470