Pre-emptive oral ganciclovir can reduce the risk of cytomegalovirus disease in liver transplant recipients

Clin Microbiol Infect. 2002 Dec;8(12):773-80. doi: 10.1046/j.1469-0691.2002.00510.x.

Abstract

A cohort of 65 liver transplant recipients was prospectively monitored with qualitative polymerase chain reaction (PCR) in plasma. The first 25 patients did not receive prophylaxis. From a consecutive group of 40 recipients, 11 high-risk patients donor CMV-seropositive/receptor CMV-seronegative (D+/R-), persistent CMV replication) received pre-emptive oral ganciclovir (1000 mg three times daily), when a marker of risk was identified, until day 90. The overall incidence of cytomegalovirus (CMV) disease at six months was 20% (five of 25 patients) in the non-prophylaxis group and 2.5% (one of 40 patients) in the group treated with pre-emptive oral ganciclovir (relative risk, 0.11; 95% confidence interval; 0.01-0.96; P = 0.04). The PCR sensitivity for detecting CMV disease was 80%, the specificity was 90%, and the positive and negative predictive values were 66% and 95%, respectively. Adverse events, graft rejection and survival were similar between groups. We conclude that pre-emptive oral ganciclovir in high-risk patients can reduce the risk of CMV disease.

Publication types

  • Clinical Conference
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use*
  • Cohort Studies
  • Cytomegalovirus / genetics
  • Cytomegalovirus / growth & development*
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / etiology
  • Cytomegalovirus Infections / prevention & control*
  • DNA, Viral / blood
  • Female
  • Ganciclovir / administration & dosage
  • Ganciclovir / therapeutic use*
  • Humans
  • Liver Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • Prospective Studies
  • Sensitivity and Specificity

Substances

  • Antiviral Agents
  • DNA, Viral
  • Ganciclovir