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- Title
Community-acquired Respiratory Viruses Are a Risk Factor for Chronic Lung Allograft Dysfunction.
- Authors
Peghin, Maddalena; Los-Arcos, Ibai; Hirsch, Hans H; Codina, Gemma; Monforte, Víctor; Bravo, Carles; Berastegui, Cristina; Jauregui, Alberto; Romero, Laura; Cabral, Evelyn; Ferrer, Ricard; Sacanell, Judith; Román, Antonio; Len, Oscar; Gavaldà, Joan
- Abstract
Background The relationship between community-acquired respiratory viruses (CARVs) and chronic lung allograft dysfunction (CLAD) in lung transplant recipients is still controversial. Methods We performed a prospective cohort study (2009–2014) in all consecutive adult patients (≥18 years) undergoing lung transplantation in the Hospital Universitari Vall d'Hebron (Barcelona, Spain). We systematically collected nasopharyngeal swabs from asymptomatic patients during seasonal changes, from patients with upper respiratory tract infectious disease, lower respiratory tract infectious disease (LRTID), or acute rejection. Nasopharyngeal swabs were analyzed by multiplex polymerase chain reaction. Primary outcome was to evaluate the potential association of CARVs and development of CLAD. Time-dependent Cox regression models were performed to identify the independent risk factors for CLAD. Results Overall, 98 patients (67 bilateral lung transplant recipients; 63.3% male; mean age, 49.9 years) were included. Mean postoperative follow-up was 3.4 years (interquartile range [IQR], 2.5–4.0 years). Thirty-eight lung transplant recipients (38.8%) developed CLAD, in a median time of 20.4 months (IQR, 12–30.4 months). In time-controlled multivariate analysis, CARV-LRTID (hazard ratio [HR], 3.00 [95% confidence interval {CI}, 1.52–5.91]; P =.002), acute rejection (HR, 2.97 [95% CI, 1.51–5.83]; P =.002), and cytomegalovirus pneumonitis (HR, 3.76 [95% CI, 1.23–11.49]; P =.02) were independent risk factors associated with developing CLAD. Conclusions Lung transplant recipients with CARVs in the lower respiratory tract are at increased risk to develop CLAD.
- Subjects
CONFIDENCE intervals; CYTOMEGALOVIRUS diseases; GRAFT rejection; HEALTH facilities; HOMOGRAFTS; PATIENT aftercare; LONGITUDINAL method; LUNG transplantation; MULTIVARIATE analysis; NASOPHARYNX; PNEUMONIA; POLYMERASE chain reaction; POSTOPERATIVE care; REGRESSION analysis; RESPIRATORY infections; RISK assessment; TRANSPLANTATION of organs, tissues, etc.; VIRUS diseases; COMMUNITY-acquired infections; PROPORTIONAL hazards models; ODDS ratio; DISEASE complications
- Publication
Clinical Infectious Diseases, 2019, Vol 69, Issue 7, p1192
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciy1047