Evaluation of cytomegalovirus infection/disease in IgG positive renal transplantation recipients on valaciclovir prophylaxis

Introduction: The reactivation of CMV (Cytomegalovirus) in renal transplant recipients may be manifested across a clinical spectrum from asymptomatic viraemia to organ rejection. The purpose of this study is to evaluate the patients who have experienced CMV infection after renal transplantation in the last twelve years, and to assess the efficacy of valacyclovir.

Methodology: Renal transplant recipients' demographic, clinical and laboratory data were evaluated retrospectively between 2006-2018. Valaciclovir was given at the standard prophylaxis dose of 2000 mg/daily. CMV Polymerase Chain reaction (PCR) was performed in 2-week intervals until 1 year after transplantation, and upon any symptoms attributable to CMV.

Results: The entire study group had D+/R+ (donor-positive, recipient-positive) serological status of the CMV virus. 171 (59.2%) patients had only CMV infection, 60 (20.8%) had overall CMV antigen positivity until the end of the follow-up period and 7 (2.4%) patients had CMV disease. Rejection episodes were diagnosed in 31 (10.8%) patients; 20 (64.5%) of those were PCR positive for CMV; mortality rate was 12 (4.2%) but those who died had a non-CMV related disease.

Conclusions: Valaciclovir may be preferred in prophylaxis instead of valganciclovir as we used in our study since valganciclovir has prolonged treatment time, rapid development of drug resistance, drug toxicity and high cost.

Comments：

This study retrospectively evaluated renal transplant recipients who experienced CMV infection between 2006-2018, and assessed the efficacy of valacyclovir as prophylaxis. The study group consisted of patients with D+/R+ serological status for CMV. CMV PCR was performed at 2-week intervals until 1 year after transplantation, and upon any symptoms attributable to CMV.

Of the 288 patients in the study, 171 (59.2%) had only CMV infection, 60 (20.8%) had overall CMV antigen positivity until the end of the follow-up period, and 7 (2.4%) patients had CMV disease. Rejection episodes were diagnosed in 31 (10.8%) patients, and 20 (64.5%) of those were PCR positive for CMV. The mortality rate was 12 (4.2%), but those who died had a non-CMV related disease.

The study concluded that valacyclovir may be preferred as prophylaxis for CMV infection in renal transplant recipients, over valganciclovir, which has a prolonged treatment time, rapid development of drug resistance, drug toxicity, and high cost.

Related Products

Cat.No.	Product Name	Information
S1876	Valaciclovir HCl	Valaciclovir HCl, an aciclovir prodrug, inhibits activity of virus DNA polymerase, used to treat infections caused by herpes simplex virus (HSV) and varicella zoster virus, and for prophylaxis against cytomegalovirus (CMV).

Related Targets

CMV