Atabani, SF; Atkinson, C; Milne, RSB; Emery, VC; Griffiths, PD; Smith, C; ... O'Riordan, A; + view all Atabani, SF; Atkinson, C; Milne, RSB; Emery, VC; Griffiths, PD; Smith, C; Aldridge, RW; Rodriguez-Perálvarez, M; Rolando, N; Burroughs, AK; Thorburn, D; O'Beirne, J; Harber, M; Jones, G; O'Riordan, A; - view fewer (2012) Cytomegalovirus replication kinetics in solid organ transplant recipients managed by preemptive therapy. American Journal of Transplantation , 12 (9) 2457 - 2464. 10.1111/j.1600-6143.2012.04087.x.
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After allotransplantation, cytomegalovirus (CMV) may be transmitted from the donor organ, giving rise to primary infection in a CMV negative recipient or reinfection in one who is CMV positive. In addition, latent CMV may reactivate in a CMV positive recipient. In this study, serial blood samples from 689 kidney or liver transplant recipients were tested for CMV DNA by quantitative PCR. CMV was managed using preemptive antiviral therapy and no patient received antiviral prophylaxis. Dynamic and quantitative measures of viremia and treatment were assessed. Median peak viral load, duration of viremia and duration of treatment were highest during primary infection, followed by reinfection then reactivation. In patients who experienced a second episode of viremia, the viral replication rate was significantly slower than in the first episode. Our data provide a clear demonstration of the immune control of CMV in immunosuppressed patients and emphasize the effectiveness of the preemptive approach for prevention of CMV syndrome and end organ disease. Overall, our findings provide quantitative biomarkers which can be used in pharmacodynamic assessments of the ability of novel CMV vaccines or antiviral drugs to reduce or even interrupt such transmission. The authors show that preemptive antiviral therapy is an effective approach for control and prevention of cytomegalovirus replication after renal and liver transplantation, even in high-risk patients. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.
|Title:||Cytomegalovirus replication kinetics in solid organ transplant recipients managed by preemptive therapy|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care > Infection and Population Health|
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