Original clinical scienceCytomegalovirus Prevention in High-risk Lung Transplant Recipients: Comparison of 3- vs 12-Month Valganciclovir Therapy
Section snippets
Study Design
Between October 2002 and November 2004, all at-risk lung transplant recipients received a combined prophylaxis with IV ganciclovir for 2 weeks and four doses (Days 1, 7, 14 and 21 post-transplant) of CMV IVIg (Cytotect; Biotest GmbH, Vienna, Austria), followed by valganciclovir for 3 months. After December 2004, all high-risk patients (D+/R−) were treated with valganciclovir for 12 months, again starting with IV ganciclovir for 2 weeks and four doses of CMV IVIg. All patients received
Results
A total of 32 patients were included in the study. Fifteen patients received 3-month CMV prophylaxis (Group A) and 17 patients had 12-month (Group B) CMV prophylaxis with valganciclovir. Mean age was 44.8 ± 16.9 years in Group A and 46.1 ± 12.5 years in Group B (p = not statistically significant [NS]). Table 1 presents data for the two groups. Follow-up was complete for all patients in both groups (mean follow-up period 996 ± 365 days).
Table 2, Table 3 and Figure 1, Figure 2 display results of
Discussion
The aim of the study was to compare the efficacy of two different prophylactic strategies in high-risk lung transplant recipients with CMV serostatus D+/R−. Both groups received CMV hyperimmunoglobulin four times: Group A received a 3-month valganciclovir prophylaxis and Group B received a 12-month prophylaxis.
Both regimens achieved good viral suppression while on therapy, with just one detectable CMV viremia in each arm. After cessation of valganciclovir prophylaxis, CMV viremia and disease
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