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Two‐year post‐transplantation cytomegalovirus DNAemia in asymptomatic kidney transplant recipients: incidence, risk factors, and outcome
Author(s) -
Viot B.,
Garrigue I.,
Taton B.,
Bachelet T.,
Moreau J.F.,
DechanetMerville J.,
Merville P.,
Couzi L.
Publication year - 2015
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12408
Subject(s) - medicine , asymptomatic , incidence (geometry) , odds ratio , cytomegalovirus , transplantation , kidney transplantation , renal function , gastroenterology , risk factor , retrospective cohort study , immunology , herpesviridae , viral disease , virus , physics , optics
Background The incidence and the impact of asymptomatic cytomegalovirus ( CMV ) DNA emia occurring after the first year post transplantation is unknown. Methods In this retrospective cross‐sectional study, we analyzed the incidence, risk factors, and impact of 2‐year post‐transplantation asymptomatic CMV DNA emia (2 YCD ) on graft function. We included 892 consecutive asymptomatic kidney transplant recipients transplanted for at least 2 years and all were monitored using whole blood CMV quantitative nucleic acid amplification testing ( CMV ‐ QNAT ). Results Twenty‐eight patients displayed 2 YCD (3.1%). Using multivariate analysis in 578 patients, we found that female gender (odds ratio [ OR ] = 2.57, P = 0.02), a past history of CMV drug‐resistance mutation ( OR = 8.73, P = 0.005), and corticosteroid use ( OR = 2.37, P = 0.03) were independently associated with an increased risk of 2 YCD . 2 YCD was associated with an increased incidence of subsequent CMV disease over the year following its diagnosis (7% vs. 0.6%, P = 0.02). Patients with 2 YCD also exhibited a declining estimated glomerular filtration rate more frequently (77%) than patients with a negative CMV ‐ QNAT (56%, P = 0.02). Conclusion 2 YCD appears to be a rare entity, which appears to be associated with chronic graft dysfunction.