22 March 2013
Treatment of Cytomegalovirus infection after renal transplantation: Experience from a Single Center in ChinaYang LiABCDEFG, Hang YanACFG, Wu-Jun XueABCDG, Pu-Xun TianACF, Xiao-Ming DingACF, Xiao-Ming PanACF, Xin-Shun FengACF, He-Li XiangACF, Jun HouACF, Xiao-Hui TianACF, Jin ZhengCF, Chen-Guang DingCF, Ping FanCEFG, Hong-Bao LiuCF
Ann Transplant 2013; 18:124-134
BACKGROUND: We compared the efficacy and safety of 2 different treatments of CMV infection, including asymptomatic CMV replication and CMV disease.
MATERIAL AND METHODS: 852 renal transplantation recipients, including asymptomatic CMV replication and CMV disease, received antiviral therapies of intravenous acyclovir or comprehensive anti-infection solution, mainly with intravenous ganciclovir. Effect, time, acute allograft rejection, and safety were analyzed during the antiviral therapy
RESULTS: The total effective rates were higher with ganciclovir in both asymptomatic CMV replication (98.96% vs. 84.90%) and CMV disease (96.29% vs. 50.36%). Ganciclovir significantly shortened antiviral therapy duration in both asymptomatic CMV replication (15.0±2.3 days vs. 16.0±3.4 days) and CMV disease (19.7±3.1 days vs. 21.5±4.0 days). The acute allograft rejection incidences were significantly lower with ganciclovir in both asymptomatic CMV replication (8% vs. 14%) and CMV disease (11% vs. 22%). CMV-IEA was detected in renal grafts of patients with acute rejection. There was more CMV-associated acute rejection using acyclovir than using ganciclovir. Except for the higher incidence of anemia leucopenia and anemia with ganciclovir, the safety profiles of both drugs were similar.
CONCLUSIONS: Comprehensive anti-infection solution, mainly with intravenous ganciclovir, can effectively treat CMV infection, shorten duration of therapy, and decrease acute rejection. The few adverse effects had negligible effects on use of ganciclovir.
Keywords: Cytomegalovirus (CMV), renal transplantation, acyclovir, Ganciclovir
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