| Extended valganciclovir prophylaxis in D+/R- kidney transplant recipients is associated with long-term reduction in cytomegalovirus disease: two-year results of the IMPACT study. | |
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MedLine Citation:
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PMID: 21197713 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Whether the early reduction in cytomegalovirus (CMV) disease seen at 1 year with prolongation of antiviral prophylaxis (up to 200 days) persists in the long term is unknown. METHODS: This international, randomized, prospective, double-blind study, compared 318 CMV D+/R- kidney transplant recipients receiving valganciclovir (900 mg) once daily for up to 200 days vs. 100 days. Long-term outcomes including CMV disease, acute rejection, graft loss, patient survival, and seroconversion were assessed. RESULTS: At 2 years posttransplant, CMV disease occurred in significantly less patients in the 200- vs. the 100-day group: 21.3% vs. 38.7%, respectively (P<0.001). Between year 1 and 2, there were only 10 new cases of CMV disease; 7 in the 200-day group and 3 in the 100-day group. Patient survival was 100% in the 200-day group and 97% in the 100-day group (p=not significant). Biopsy-proven acute rejection and graft loss rates were comparable in both groups (11.6% vs. 17.2%, P=0.16, and 1.9% vs. 4.3%, P=0.22, in the 200-day vs. 100-day groups, respectively). Seroconversion was delayed in the 200-day group but was similar to the 100-day group by 2 years posttransplant (IgM or IgG seroconversion; 55.5% in the 200-day group vs. 62.0% in the 100-day group at 2-years; P=0.26). Assessment of seroconversion at the end of prophylaxis was of limited utility for predicting late-onset CMV disease. CONCLUSION: Extending valganciclovir prophylaxis from 100 to 200 days is associated with a sustained reduction in CMV disease up to 2 years posttransplant. |
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Authors:
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Atul Humar; Ajit P Limaye; Emily A Blumberg; Ingeborg A Hauser; Flavio Vincenti; Alan G Jardine; Daniel Abramowicz; Jane A L Ives; Mahdi Farhan; Patrick Peeters |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Transplantation Volume: 90 ISSN: 1534-6080 ISO Abbreviation: Transplantation Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-30 Completed Date: 2011-01-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0132144 Medline TA: Transplantation Country: United States |
Other Details:
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Languages: eng Pagination: 1427-31 Citation Subset: IM |
Affiliation:
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Transplant Infectious Diseases, University of Alberta, Edmonton, AB, Canada. ahumar@ualberta.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antiviral Agents
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administration & dosage,
therapeutic use* Cytomegalovirus Infections / epidemiology, prevention & control* Double-Blind Method Follow-Up Studies Ganciclovir / administration & dosage, analogs & derivatives*, therapeutic use Graft Survival Humans Immunoglobulin G / blood Immunoglobulin M / blood Kidney Transplantation / adverse effects, mortality, physiology* Likelihood Functions Predictive Value of Tests Prospective Studies Serologic Tests / statistics & numerical data Survival Rate Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Antiviral Agents; 0/Immunoglobulin G; 0/Immunoglobulin M; 0/valganciclovir; 82410-32-0/Ganciclovir |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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