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Among CMV‐positive renal transplant patients receiving non‐T‐cell depleting induction, the absence of CMV disease prevention is a safe strategy: A retrospective cohort of 372 patients
Author(s) -
Boulay Hugoline,
Oger Emmanuel,
Cantarovich Diego,
Gatault Philippe,
Thierry Antoine,
Le Meur Yannick,
Duveau Agnès,
Vigneau Cécile,
Lorcy Nolwenn
Publication year - 2021
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.13541
Subject(s) - medicine , valganciclovir , cytomegalovirus , disease , transplantation , retrospective cohort study , incidence (geometry) , cohort , cytomegalovirus infection , gastroenterology , immunology , human cytomegalovirus , virus , viral disease , herpesviridae , physics , optics
Cytomegalovirus (CMV) is the most common opportunistic pathogen affecting renal transplant recipients, especially in the first months. CMV‐seropositive renal transplant recipients (CMV R+) are at intermediate risk for CMV disease, but this risk is enhanced among CMV R+ receiving T‐cell depleting induction, compared to CMV R+ receiving non‐depleting induction. In this second group, data in favor of prophylactic antiviral treatment with valganciclovir to reduce CMV disease is sparse. In this retrospective and multicentric trial, we included 372 CMV R+ transplanted between January 2012 and April 2015 and receiving non‐depleting induction. During the first year following transplantation, CMV disease occurred in 5/222 patients (2.25%) in the prophylaxis group and 9/150 (6%) in the no‐prophylaxis group (difference +3.7; 95% CI: 0.5‐8; P = .002 for non‐inferiority). The incidence of allograft rejection and other infectious diseases was similar between the two groups. Graft and patient survival were similar at the end of follow‐up. In conclusion, the absence of prophylaxis did not appear to have a deleterious effect for CMV diseases among CMV R+ receiving non‐depleting induction.