The impact of cytomegalovirus disease and asymptomatic infection on acute renal allograft rejection
Cytomegalovirus (CMV) disease is a risk factor for allograft rejection in renal transplant (RTx) recipients. However, the role of asymptomatic CMV infection remains controversial. To determine the impact of CMV disease and asymptomatic infection on biopsy-proven acute rejection (BPAR) during 12 mont...
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| Veröffentlicht in: | Journal of clinical virology 2006-06, Vol.36 (2), p.146-151 |
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| creator | Reischig, Tomáš Jindra, Pavel Švecová, Miroslava Kormunda, Stanislav Opatrný, Karel Třeška, Vladislav |
| description | Cytomegalovirus (CMV) disease is a risk factor for allograft rejection in renal transplant (RTx) recipients. However, the role of asymptomatic CMV infection remains controversial.
To determine the impact of CMV disease and asymptomatic infection on biopsy-proven acute rejection (BPAR) during 12 months post-RTx.
A total of 106 consecutive RTx recipients at risk for CMV (donor and/or recipient CMV seropositive) were followed prospectively for 12 months post-RTx. CMV activity was monitored using nested PCR from whole blood. Three-month prophylaxis with valacyclovir or ganciclovir was given to 94 patients. BPAR episodes were classified according to the Banff 97 criteria. Multivariate Cox proportional hazards model was used to estimate the effect of CMV disease, asymptomatic infection, and other covariates on BPAR.
Asymptomatic CMV infection occurred in 23% of the patients and 10% developed CMV disease. The incidence of BPAR was 29%. CMV disease was an independent risk factor for BPAR (HR
=
3.0,
P
=
0.014), while asymptomatic CMV infection was not (
P
=
0.987). In addition to CMV disease, expanded criteria donor and donor age were independent predictors for BPAR. In univariate analysis, valacyclovir (HR
=
0.26,
P
=
0.008) decreased the risk of BPAR. A similar trend was observed with ganciclovir (HR
=
0.42,
P
=
0.058). Only valacyclovir remained significant in multivariate analysis (HR
=
0.18,
P
=
0.044).
CMV disease, but not asymptomatic infection, is an independent risk factor for BPAR during the first 12 months post-RTx. |
| doi_str_mv | 10.1016/j.jcv.2006.01.015 |
| format | Article |
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To determine the impact of CMV disease and asymptomatic infection on biopsy-proven acute rejection (BPAR) during 12 months post-RTx.
A total of 106 consecutive RTx recipients at risk for CMV (donor and/or recipient CMV seropositive) were followed prospectively for 12 months post-RTx. CMV activity was monitored using nested PCR from whole blood. Three-month prophylaxis with valacyclovir or ganciclovir was given to 94 patients. BPAR episodes were classified according to the Banff 97 criteria. Multivariate Cox proportional hazards model was used to estimate the effect of CMV disease, asymptomatic infection, and other covariates on BPAR.
Asymptomatic CMV infection occurred in 23% of the patients and 10% developed CMV disease. The incidence of BPAR was 29%. CMV disease was an independent risk factor for BPAR (HR
=
3.0,
P
=
0.014), while asymptomatic CMV infection was not (
P
=
0.987). In addition to CMV disease, expanded criteria donor and donor age were independent predictors for BPAR. In univariate analysis, valacyclovir (HR
=
0.26,
P
=
0.008) decreased the risk of BPAR. A similar trend was observed with ganciclovir (HR
=
0.42,
P
=
0.058). Only valacyclovir remained significant in multivariate analysis (HR
=
0.18,
P
=
0.044).
CMV disease, but not asymptomatic infection, is an independent risk factor for BPAR during the first 12 months post-RTx.</description><identifier>ISSN: 1386-6532</identifier><identifier>EISSN: 1873-5967</identifier><identifier>DOI: 10.1016/j.jcv.2006.01.015</identifier><identifier>PMID: 16531113</identifier><language>eng</language><publisher>Amsterdam: Elsevier B.V</publisher><subject>Acute Disease ; Acyclovir - analogs & derivatives ; Acyclovir - therapeutic use ; Antiviral Agents - therapeutic use ; Biological and medical sciences ; Carrier State ; Cytomegalovirus ; Cytomegalovirus - genetics ; Cytomegalovirus - isolation & purification ; Cytomegalovirus Infections - complications ; Cytomegalovirus Infections - prevention & control ; Cytomegalovirus Infections - virology ; Female ; Fundamental and applied biological sciences. Psychology ; Ganciclovir ; Ganciclovir - therapeutic use ; Graft Rejection - epidemiology ; Graft Rejection - etiology ; Human viral diseases ; Humans ; Incidence ; Infectious diseases ; Kidney Transplantation - adverse effects ; Male ; Medical sciences ; Microbiology ; Middle Aged ; Miscellaneous ; Multivariate Analysis ; Postoperative Complications - prevention & control ; Prospective Studies ; Rejection ; Renal transplantation ; Risk Factors ; Treatment Outcome ; Valacyclovir ; Valine - analogs & derivatives ; Valine - therapeutic use ; Viral diseases ; Virology</subject><ispartof>Journal of clinical virology, 2006-06, Vol.36 (2), p.146-151</ispartof><rights>2006 Elsevier B.V.</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-7350465a2dc7f8966b9416dcd06a2d45cc3cacf593d82e79a1d6ad208f6991d23</citedby><cites>FETCH-LOGICAL-c478t-7350465a2dc7f8966b9416dcd06a2d45cc3cacf593d82e79a1d6ad208f6991d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcv.2006.01.015$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17799515$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16531113$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reischig, Tomáš</creatorcontrib><creatorcontrib>Jindra, Pavel</creatorcontrib><creatorcontrib>Švecová, Miroslava</creatorcontrib><creatorcontrib>Kormunda, Stanislav</creatorcontrib><creatorcontrib>Opatrný, Karel</creatorcontrib><creatorcontrib>Třeška, Vladislav</creatorcontrib><title>The impact of cytomegalovirus disease and asymptomatic infection on acute renal allograft rejection</title><title>Journal of clinical virology</title><addtitle>J Clin Virol</addtitle><description>Cytomegalovirus (CMV) disease is a risk factor for allograft rejection in renal transplant (RTx) recipients. However, the role of asymptomatic CMV infection remains controversial.
To determine the impact of CMV disease and asymptomatic infection on biopsy-proven acute rejection (BPAR) during 12 months post-RTx.
A total of 106 consecutive RTx recipients at risk for CMV (donor and/or recipient CMV seropositive) were followed prospectively for 12 months post-RTx. CMV activity was monitored using nested PCR from whole blood. Three-month prophylaxis with valacyclovir or ganciclovir was given to 94 patients. BPAR episodes were classified according to the Banff 97 criteria. Multivariate Cox proportional hazards model was used to estimate the effect of CMV disease, asymptomatic infection, and other covariates on BPAR.
Asymptomatic CMV infection occurred in 23% of the patients and 10% developed CMV disease. The incidence of BPAR was 29%. CMV disease was an independent risk factor for BPAR (HR
=
3.0,
P
=
0.014), while asymptomatic CMV infection was not (
P
=
0.987). In addition to CMV disease, expanded criteria donor and donor age were independent predictors for BPAR. In univariate analysis, valacyclovir (HR
=
0.26,
P
=
0.008) decreased the risk of BPAR. A similar trend was observed with ganciclovir (HR
=
0.42,
P
=
0.058). Only valacyclovir remained significant in multivariate analysis (HR
=
0.18,
P
=
0.044).
CMV disease, but not asymptomatic infection, is an independent risk factor for BPAR during the first 12 months post-RTx.</description><subject>Acute Disease</subject><subject>Acyclovir - analogs & derivatives</subject><subject>Acyclovir - therapeutic use</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Carrier State</subject><subject>Cytomegalovirus</subject><subject>Cytomegalovirus - genetics</subject><subject>Cytomegalovirus - isolation & purification</subject><subject>Cytomegalovirus Infections - complications</subject><subject>Cytomegalovirus Infections - prevention & control</subject><subject>Cytomegalovirus Infections - virology</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Ganciclovir</subject><subject>Ganciclovir - therapeutic use</subject><subject>Graft Rejection - epidemiology</subject><subject>Graft Rejection - etiology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infectious diseases</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Multivariate Analysis</subject><subject>Postoperative Complications - prevention & control</subject><subject>Prospective Studies</subject><subject>Rejection</subject><subject>Renal transplantation</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Valacyclovir</subject><subject>Valine - analogs & derivatives</subject><subject>Valine - therapeutic use</subject><subject>Viral diseases</subject><subject>Virology</subject><issn>1386-6532</issn><issn>1873-5967</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkctqHDEQRYWJiZ1JPiCboE2y67EeLalFVsHkBYZsnLUolyRHTT8mUvfA_L01ngHvEigoqXR0Ke4l5D1nW864vum3Pe63gjG9ZbyWuiDXvDOyUVabV_UsO91oJcUVeVNKzyohW_OaXPE65JzLa4L3fwJN4w5woXOkeFjmMTzCMO9TXgv1qQQogcLkKZTDuKvPsCSkaYoBlzRPtBbgugSawwQDhWGYHzPEpd77E_KWXEYYSnh37hvy-9vX-9sfzd2v7z9vv9w12JpuaYxUrNUKhEcTO6v1g2259uiZrrNWIUoEjMpK34lgLHCvwQvWRW0t90JuyKeT7i7Pf9dQFjemgmEYYArzWpw21mgl2v-C3AguhekqyE8g5rmUHKLb5TRCPjjO3DEC17sagTtG4Bh3R4M35MNZfH0Yg3_5cfa8Ah_PABSEIWaYMJUXzhhr1bPQ5xMXqmf7FLIrmMKEwadcjXV-Tv9Y4wkKc6UN</recordid><startdate>20060601</startdate><enddate>20060601</enddate><creator>Reischig, Tomáš</creator><creator>Jindra, Pavel</creator><creator>Švecová, Miroslava</creator><creator>Kormunda, Stanislav</creator><creator>Opatrný, Karel</creator><creator>Třeška, Vladislav</creator><general>Elsevier B.V</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20060601</creationdate><title>The impact of cytomegalovirus disease and asymptomatic infection on acute renal allograft rejection</title><author>Reischig, Tomáš ; Jindra, Pavel ; Švecová, Miroslava ; Kormunda, Stanislav ; Opatrný, Karel ; Třeška, Vladislav</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-7350465a2dc7f8966b9416dcd06a2d45cc3cacf593d82e79a1d6ad208f6991d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Acute Disease</topic><topic>Acyclovir - analogs & derivatives</topic><topic>Acyclovir - therapeutic use</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Carrier State</topic><topic>Cytomegalovirus</topic><topic>Cytomegalovirus - genetics</topic><topic>Cytomegalovirus - isolation & purification</topic><topic>Cytomegalovirus Infections - complications</topic><topic>Cytomegalovirus Infections - prevention & control</topic><topic>Cytomegalovirus Infections - virology</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Ganciclovir</topic><topic>Ganciclovir - therapeutic use</topic><topic>Graft Rejection - epidemiology</topic><topic>Graft Rejection - etiology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infectious diseases</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Multivariate Analysis</topic><topic>Postoperative Complications - prevention & control</topic><topic>Prospective Studies</topic><topic>Rejection</topic><topic>Renal transplantation</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Valacyclovir</topic><topic>Valine - analogs & derivatives</topic><topic>Valine - therapeutic use</topic><topic>Viral diseases</topic><topic>Virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reischig, Tomáš</creatorcontrib><creatorcontrib>Jindra, Pavel</creatorcontrib><creatorcontrib>Švecová, Miroslava</creatorcontrib><creatorcontrib>Kormunda, Stanislav</creatorcontrib><creatorcontrib>Opatrný, Karel</creatorcontrib><creatorcontrib>Třeška, Vladislav</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of clinical virology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reischig, Tomáš</au><au>Jindra, Pavel</au><au>Švecová, Miroslava</au><au>Kormunda, Stanislav</au><au>Opatrný, Karel</au><au>Třeška, Vladislav</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of cytomegalovirus disease and asymptomatic infection on acute renal allograft rejection</atitle><jtitle>Journal of clinical virology</jtitle><addtitle>J Clin Virol</addtitle><date>2006-06-01</date><risdate>2006</risdate><volume>36</volume><issue>2</issue><spage>146</spage><epage>151</epage><pages>146-151</pages><issn>1386-6532</issn><eissn>1873-5967</eissn><abstract>Cytomegalovirus (CMV) disease is a risk factor for allograft rejection in renal transplant (RTx) recipients. However, the role of asymptomatic CMV infection remains controversial.
To determine the impact of CMV disease and asymptomatic infection on biopsy-proven acute rejection (BPAR) during 12 months post-RTx.
A total of 106 consecutive RTx recipients at risk for CMV (donor and/or recipient CMV seropositive) were followed prospectively for 12 months post-RTx. CMV activity was monitored using nested PCR from whole blood. Three-month prophylaxis with valacyclovir or ganciclovir was given to 94 patients. BPAR episodes were classified according to the Banff 97 criteria. Multivariate Cox proportional hazards model was used to estimate the effect of CMV disease, asymptomatic infection, and other covariates on BPAR.
Asymptomatic CMV infection occurred in 23% of the patients and 10% developed CMV disease. The incidence of BPAR was 29%. CMV disease was an independent risk factor for BPAR (HR
=
3.0,
P
=
0.014), while asymptomatic CMV infection was not (
P
=
0.987). In addition to CMV disease, expanded criteria donor and donor age were independent predictors for BPAR. In univariate analysis, valacyclovir (HR
=
0.26,
P
=
0.008) decreased the risk of BPAR. A similar trend was observed with ganciclovir (HR
=
0.42,
P
=
0.058). Only valacyclovir remained significant in multivariate analysis (HR
=
0.18,
P
=
0.044).
CMV disease, but not asymptomatic infection, is an independent risk factor for BPAR during the first 12 months post-RTx.</abstract><cop>Amsterdam</cop><pub>Elsevier B.V</pub><pmid>16531113</pmid><doi>10.1016/j.jcv.2006.01.015</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of clinical virology, 2006-06, Vol.36 (2), p.146-151 |
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| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | Acute Disease Acyclovir - analogs & derivatives Acyclovir - therapeutic use Antiviral Agents - therapeutic use Biological and medical sciences Carrier State Cytomegalovirus Cytomegalovirus - genetics Cytomegalovirus - isolation & purification Cytomegalovirus Infections - complications Cytomegalovirus Infections - prevention & control Cytomegalovirus Infections - virology Female Fundamental and applied biological sciences. Psychology Ganciclovir Ganciclovir - therapeutic use Graft Rejection - epidemiology Graft Rejection - etiology Human viral diseases Humans Incidence Infectious diseases Kidney Transplantation - adverse effects Male Medical sciences Microbiology Middle Aged Miscellaneous Multivariate Analysis Postoperative Complications - prevention & control Prospective Studies Rejection Renal transplantation Risk Factors Treatment Outcome Valacyclovir Valine - analogs & derivatives Valine - therapeutic use Viral diseases Virology |
| title | The impact of cytomegalovirus disease and asymptomatic infection on acute renal allograft rejection |
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