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Title: Preventive Strategies Against Cytomegalovirus and Incidence of α-Herpesvirus Infections in Solid Organ Transplant Recipients: A Nationwide Cohort Study.
Authors: Martin-Gandul, C
Stampf, S
Héquet, D
Mueller, N J
Cusini, A
van Delden, C
Khanna, N
Boggian, K
Hirzel, C
Soccal, P
Hirsch, H H
Pascual, M
Meylan, P
Manuel, O
Swiss Transplant Cohort Study (STCS)
Keywords: antibiotic: antiviral-ganciclovir/valganciclovir;clinical research/practice;infection and infectious agents;infectious disease;viral;viral: herpes zoster/Varicella
metadata.dc.subject.mesh: Adult
Antiviral Agents
Cohort Studies
Cytomegalovirus Infections
Follow-Up Studies
Graft Rejection
Graft Survival
Herpesviridae Infections
Herpesvirus 3, Human
Middle Aged
Organ Transplantation
Risk Factors
Transplant Recipients
Issue Date: 2-Feb-2017
Abstract: We assessed the impact of antiviral preventive strategies on the incidence of herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections in a nationwide cohort of transplant recipients. Risk factors for the development of HSV or VZV infection were assessed by Cox proportional hazards regression. We included 2781 patients (56% kidney, 20% liver, 10% lung, 7.3% heart, 6.7% others). Overall, 1264 (45%) patients received antiviral prophylaxis (ganciclovir or valganciclovir, n = 1145; acyclovir or valacyclovir, n = 138). Incidence of HSV and VZV infections was 28.9 and 12.1 cases, respectively, per 1000 person-years. Incidence of HSV and VZV infections at 1 year after transplant was 4.6% (95% confidence interval [CI] 3.5-5.8) in patients receiving antiviral prophylaxis versus 12.3% (95% CI 10.7-14) in patients without prophylaxis; this was observed particularly for HSV infections (3% [95% CI 2.2-4] versus 9.8% [95% CI 8.4-11.4], respectively). A lower rate of HSV and VZV infections was also seen in donor or recipient cytomegalovirus-positive patients receiving ganciclovir or valganciclovir prophylaxis compared with a preemptive approach. Female sex (hazard ratio [HR] 1.663, p = 0.001), HSV seropositivity (HR 5.198, p
metadata.dc.identifier.doi: 10.1111/ajt.14192
Appears in Collections:Producción 2020

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