Valacyclovir for the prevention of cytomegalovirus infection after kidney transplantation

被引：0

作者：

Kim, Jin Sug ^{[1
]}

Lee, Na Rae ^{[2
]}

Park, Kyun-Ik ^{[2
]}

Hwang, Hyeon Seok ^{[1
]}

Lee, Sang Ho ^{[3
]}

Chung, Byung Ha ^{[4
]}

Jung, Cheol Woong ^{[5
]}

Cho, Jang-Hee ^{[6
]}

Park, Woo Yeong ^{[7
]}

Kim, Hyo Jin ^{[8
]}

Jeong, Jong Cheol ^{[9
]}

Yang, Jaeseok ^{[10
]}

Lee, Yu Ho ^{[11
]}

Park, Jae Berm ^{[12
]}

Jeon, Jin Seok ^{[13
]}

Lee, Juhan ^{[14
]}

Kim, Yeong Hoon ^{[15
]}

Choi, Soo Jin Na ^{[16
]}

Oh, Jieun ^{[17
]}

Yoon, Hye Eun ^{[18
]}

Kim, Deok Gie ^{[19
]}

Shin, Ho Sik ^{[20
,21
]}

Ban, Tae Hyun ^{[22
]}

Kim, Myoung Soo ^{[14
]}

Ko, Min Jung ^{[2
]}

Jeong, Kyung Hwan ^{[1
]}

机构：

[1] Kyung Hee Univ, Med Ctr, Coll Med, Div Nephrol,Dept Internal Med, 26 Kyungheedae Ro, Seoul 02447, South Korea

[2] Natl Evidence Based Healthcare Collaborating Agcy, Div Healthcare Technol Assessment Res, 400 Neungdong Ro, Seoul 04933, South Korea

[3] Kyung Hee Univ, Coll Med, Kyung Hee Univ Hosp Gangdong, Div Nephrol,Coll Med, 892 Dongnam Ro, Seoul 05278, South Korea

[4] Seoul St Marys Hosp, Dept Internal Med, Div Nephrol, Seoul, South Korea

[5] Korea Univ, Anam Hosp, Dept Surg, Seoul, South Korea

[6] Kyungpook Natl Univ, Chilgok Hosp, Sch Med, Daegu, South Korea

[7] Keimyung Univ, Dongsan Hosp, Dept Internal Med, Div Nephrol,Sch Med, Daegu 42601, South Korea

[8] Pusan Natl Univ, Pusan Natl Univ Hosp, Div Nephrol, Div Nephrol,Sch Med, Busan, South Korea

[9] Seoul Natl Univ, Bundang Hosp, Dept Neurosurg, Seongnam, South Korea

[10] Yonsei Univ, Severance Hosp, Dept Internal Med, Div Nephrol,Coll Med, 50 Yonsei Ro, Seoul, South Korea

[11] CHA Univ, CHA Bundang Med Ctr, Dept Internal Med, Div Nephrol, Seongnam, South Korea

[12] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Surg, Seoul, South Korea

[13] Soonchunhyang Univ, Seoul Hosp, Dept Internal Med, Seoul, South Korea

[14] Yonsei Univ, Coll Med, Dept Surg, Seoul, South Korea

[15] Inje Univ, Busan Paik Hosp, Dept Internal Med, Busan, South Korea

[16] Chonnam Natl Univ, Med Sch, Dept Surg, Gwangju, South Korea

[17] Hallym Univ, Coll Med, Kangdong Sacred Heart Hosp, Dept Internal Med, Seoul, South Korea

[18] Catholic Univ Korea, Incheon St Marys Hosp, Coll Med, Div Nephrol,Dept Internal Med, Incheon 21431, South Korea

[19] Yonsei Univ, Wonju Severance Christian Hosp, Dept Surg, Wonju Coll Med, Wonju, South Korea

[20] Kosin Univ, Coll Med, Dept Internal Med, Renal Div,Coll Med, Busan 602703, South Korea

[21] Kosin Univ, Coll Med, Dept Pathol, Busan 602702, South Korea

[22] Catholic Univ Korea, Eunpyeong St Marys Hosp, Coll Med, Div Nephrol,Dept Internal Med, Seoul, South Korea

来源：

BMC INFECTIOUS DISEASES | 2025年 / 25卷 / 01期

关键词：

Cytomegalovirus; Kidney transplantation; Valacyclovir; CONSENSUS GUIDELINES; ORAL GANCICLOVIR; VIRAL-INFECTION; PROPHYLAXIS; DISEASE; MANAGEMENT; RECIPIENTS; THERAPY; VALGANCICLOVIR; SEROPREVALENCE;

D O I：

10.1186/s12879-025-10671-6

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

BackgroundCytomegalovirus (CMV) infection is a frequent complication after kidney transplantation (KT) and has various effects on recipient and graft survival. Although guidelines recommend anti-viral prophylaxis with ganciclovir or valganciclovir, there is a demand for alternative regimen for CMV prevention. We investigated the effects of a 3-month valacyclovir-based prophylaxis on CMV infection and clinical outcomes in KT recipients using a nationwide cohort.MethodsOverall, 2,584 KT recipients from 20 transplant centers registered with the Korean Organ Transplantation Registry between May 2014 and December 2019 were analyzed in this study. The recipients were divided into valacyclovir prophylaxis and non-prophylaxis groups, a 1:3 propensity score matching was performed, and 1,036 recipients (291 and 745 in the prophylaxis and non-prophylaxis groups, respectively) were analyzed. The impact of valacyclovir-based prophylaxis on CMV after KT, other clinical outcomes, and the risk factors for CMV infection development were investigated.ResultsThe prophylaxis group showed a lower incidence of CMV infection and rejection compared to the non-prophylaxis group (3.64 vs. 10.25 events/100 person-years and 1.85 vs. 7.27 events/100 person-years, respectively). Valacyclovir prophylaxis, donor age, deceased donor, length of hospitalization after KT, anti-thymocyte globulin use, and CMV serological mismatch between the donor and recipient were independent risk factors for CMV infection after KT.ConclusionsValacyclovir prophylaxis after KT significantly reduced CMV infection and rejection. We suggest that valacyclovir could be considered as an alternative strategy for CMV prophylaxis after KT. However, our study has limitations, including its retrospective design, variability in valacyclovir dosing and CMV monitoring, and unassessed confounding factors. Further prospective studies with standardized protocols and larger cohorts are needed to validate our findings.

引用

页数：13

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