Late-onset CMV disease following CMV prophylaxis

Ir J Med Sci. 2009 Sep;178(3):333-6. doi: 10.1007/s11845-009-0327-3. Epub 2009 Apr 2.

Abstract

Background: Cytomegalovirus (CMV) is the most common opportunistic infection after solid-organ transplantation, increasing morbidity and mortality. Three months of oral valganciclovir have been shown to provide effective prophylaxis. Late-onset CMV disease, occurring after the discontinuation of prophylaxis, is now increasingly recognised.

Aims: To investigate the incidence and the time of detection of CMV infections in liver transplant recipients who received CMV prophylaxis.

Methods: Retrospective review of 64 high- and moderate-risk patients with 1 year of follow-up.

Results: The incidence of CMV infection was 12.5%, with 4.7% disease. All cases of symptomatic CMV disease were of late-onset.

Conclusions: The incidence of CMV infections in this study was low compared with literature reports; however, the late-onset disease is an emerging problem. Detection of late-onset disease may be delayed because of less frequent clinic follow-up visits. Increased regular laboratory monitoring may allow earlier detection at the asymptomatic infection stage.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antiviral Agents / therapeutic use
  • Confidence Intervals
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / prevention & control*
  • Cytomegalovirus*
  • Female
  • Ganciclovir / analogs & derivatives*
  • Ganciclovir / therapeutic use
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Valganciclovir
  • Young Adult

Substances

  • Antiviral Agents
  • Valganciclovir
  • Ganciclovir