Open AccessPredictors of breakthrough clinically significant cytomegalovirus infection during letermovir prophylaxis in high‐risk hematopoietic cell transplant recipients
Author(s) -
Royston Léna,
Royston Eva,
MasouridiLevrat Stavroula,
Chalandon Yves,
Van Delden Christian,
Neofytos Dionysios
Publication year - 2021
Publication title -
immunity, inflammation and disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 18
ISSN - 2050-4527
DOI - 10.1002/iid3.431
Subject(s) - medicine , cytomegalovirus infection , cytomegalovirus , hematopoietic cell , incidence (geometry) , retrospective cohort study , cohort , immunology , haematopoiesis , human immunodeficiency virus (hiv) , human cytomegalovirus , viral disease , virus , herpesviridae , stem cell , physics , biology , optics , genetics
Letermovir prophylaxis in allogeneic hematopoietic cell transplant recipients significantly reduces the incidence of clinically significant cytomegalovirus infection. However, breakthrough infections still occur despite adequate prophylaxis. In the present retrospective cohort study, we identified clinically relevant predictive factors for clinically significant CMV breakthrough infection during letermovir prophylaxis. Low‐grade CMV replication (21–149 IU/ml), both at the time of letermovir initiation or during prophylaxis, was a significant risk factor for breakthrough clinically significant CMV infection. In addition, development of acute gastrointestinal graft‐versus‐host disease was significantly associated with breakthrough infection. Altogether these findings could call clinicians' attention to closer CMV monitoring and allow for prompt preemptive treatment initiation.