Document Detail


(Val-)Ganciclovir prophylaxis reduces Epstein-Barr virus primary infection in pediatric renal transplantation.
MedLine Citation:
PMID:  22533698     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Epstein-Barr virus (EBV) primary infection constitutes a serious risk for pediatric transplant recipients, particularly as regards the development of EBV-related post-transplant lymphoproliferative disease (PTLD). Currently, there is no established prophylactic regimen. We investigated the association between chemoprophylaxis with valganciclovir (VGCV) or ganciclovir (GCV) and the incidence of EBV viremia in EBV-naïve pediatric renal transplant recipients (R-) who had received a graft from an EBV-positive donor (D+) and are therefore at high risk of EBV primary infection. In a prospective, multicenter trial (n = 114), we compared a cohort on chemoprophylaxis (n = 20) with a similar control cohort without chemoprophylaxis (n = 8). Over the 1-year study period, antiviral prophylaxis with VGCV/GCV was associated with a significantly decreased incidence of EBV primary infection: 9/20 patients (45%) in the prophylaxis group experienced an EBV primary infection compared to 8/8 controls (100%) (P < 0.0001). Chemoprophylaxis was associated with a significantly lower EBV viral load (P < 0.001). Type or intensity of immunosuppressive therapy did not influence the occurrence of EBV primary infection or the level/persistence of EBV viral load. Chemoprophylaxis with VGCV/GCV is associated with a reduced incidence of EBV viremia in high-risk pediatric kidney allograft recipients in the first year post-transplant. (ClinicalTrials.gov number: NCT00963248).
Authors:
Britta Höcker; Stephan Böhm; Helmut Fickenscher; Uta Küsters; Paul Schnitzler; Martin Pohl; Ulrike John; Markus J Kemper; Henry Fehrenbach; Marianne Wigger; Martin Holder; Monika Schröder; Reinhard Feneberg; Sabine Köpf-Shakib; Burkhard Tönshoff
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-25
Journal Detail:
Title:  Transplant international : official journal of the European Society for Organ Transplantation     Volume:  -     ISSN:  1432-2277     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908516     Medline TA:  Transpl Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Transplant International © 2012 European Society for Organ Transplantation.
Affiliation:
 University Children's Hospital, Heidelberg, Germany  Department of Infectious Diseases, Virology, University of Heidelberg, Heidelberg, Germany  Department of Gastroenterology, University Hospital Leipzig, Leipzig, Germany  Institute for Infection Medicine, University of Kiel, Kiel, Germany  University Children's Hospital, Freiburg, Germany  University Children's Hospital, Jena, Germany  University Children's Hospital, Hamburg, Germany  Children's Hospital, Memmingen, Germany  University Children's Hospital, Rostock, Germany  Olga Children's Hospital, Stuttgart, Germany  Clementine Children's Hospital, Frankfurt, Germany.
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