Cytomegalovirus prophylaxis with valganciclovir in cytomegalovirus-seropositive kidney-transplant patients

✍ Scribed by Hugo Wéclawiak; Nassim Kamar; Catherine Mengelle; Joëlle Guitard; Laure Esposito; Laurence Lavayssière; Olivier Cointault; David Ribes; Lionel Rostaing

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 70 KB
• Volume: 80
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/jmv.21183

✦ Synopsis

Abstract

The aims of this prospective, open‐label, single‐center pilot study were to assess the efficacy and safety of human cytomegalovirus (HCMV) prophylaxis using valganciclovir in HCMV‐ seropositive kidney‐transplant patients to prevent HCMV infection and disease. Fifty‐one HCMV seropositive kidney‐transplant patients recipients who received transplants between 1 December 2005 and 30 November 2006 were included in the study. Valganciclovir was given from transplantation up to 114 (37–329) days, and was adapted to renal function, i.e., 900 mg/d if calculated creatinine clearance was >60 ml/min, or 450 mg/day if it was <60 ml/min. HCMV DNAemia was assessed every 2 weeks during prophylaxis, and on the same basis for 3 months post‐prophylaxis. Immunosuppression was based on calcineurin inhibitors (ciclosporine A = 22; tacrolimus = 11), with mycophenolate mofetil (n = 51), and low‐dose steroids. Eighteen patients received no calcineurin‐inhibitors, but Belatacept instead. During valganciclovir prophylaxis, asymptomatic HCMV DNAemia was observed in one patient, and no case of HCMV disease occurred. Within 252 days (45–425) post‐valganciclovir prophylaxis, HCMV DNAemia was detected in 23.5% (n = 12) of patients, of whom two had two or more consecutive HCMV DNAemias. Valganciclovir prophylaxis in HCMV‐seropositive kidney‐transplant patients is effective for preventing cytomegalovirus disease. J. Med. Virol. 80: 1228–1232, 2008. © 2008 Wiley‐Liss, Inc.