The impact of viral load and time to onset of cytomegalovirus replication on long-term graft survival after kidney transplantation

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11140%2F17%3A10364820" target="_blank" >RIV/00216208:11140/17:10364820 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00023001:_____/17:00076331

Výsledek na webu

<a href="https://www.intmedpress.com/journals/avt/abstract.cfm?id=3129&pid=31" target="_blank" >https://www.intmedpress.com/journals/avt/abstract.cfm?id=3129&pid=31</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3851/IMP3129" target="_blank" >10.3851/IMP3129</a>

Jazyk výsledku

angličtina

Název v původním jazyce

The impact of viral load and time to onset of cytomegalovirus replication on long-term graft survival after kidney transplantation

Popis výsledku v původním jazyce

Background: Asymptomatic cytomegalovirus (CMV) infection is associated with graft dysfunction and failure. However, no study assessed CMV viral load in terms of the risk for graft failure. Methods: In prospective cohort of kidney transplant recipients, we assessed the impact of CMV DNAemia on the overall graft survival and the incidence of moderate-to-severe interstitial fibrosis and tubular atrophy (IF/TA) in protocol biopsy at 36 months. CMV DNAemia was stratified by viral load in whole blood. Results: A total of 180 patients transplanted from October 2003 through January 2011 were included and followed for 4 years; 87 (48%) patients received 3-month prophylaxis with valacyclovir and 45 (25%) with valganciclovir; 48 (27%) were managed by preemptive therapy. Within 12 months of transplantation, CMV DNAemia developed in 102 (57%) patients with 36 (20%) having a viral load of GREATER-THAN OR EQUAL TO2000 copies/ml. Multivariate Cox analysis identified CMV DNAemia as an independent risk factor for graft loss (hazard ratio 3.42, P=0.020); however, after stratification by viral load, only CMV DNAemia GREATER-THAN OR EQUAL TO2000 copies/ml (hazard ratio 7.62, P&lt;0.001) remained significant. Both early-onset (&lt;3 months, P=0.048) and late-onset (&gt;3 months, P&lt;0.001) CMV DNAemia GREATER-THAN OR EQUAL TO2000 copies/ml were risk factors for graft loss. The incidence of moderate-to-severe IF/TA was not significantly influenced by CMV DNAemia. Conclusions: Kidney transplant recipients having CMV DNAemia with a higher viral load irrespective of the time to onset are at increased risk for graft loss.

Název v anglickém jazyce

The impact of viral load and time to onset of cytomegalovirus replication on long-term graft survival after kidney transplantation

Popis výsledku anglicky

Background: Asymptomatic cytomegalovirus (CMV) infection is associated with graft dysfunction and failure. However, no study assessed CMV viral load in terms of the risk for graft failure. Methods: In prospective cohort of kidney transplant recipients, we assessed the impact of CMV DNAemia on the overall graft survival and the incidence of moderate-to-severe interstitial fibrosis and tubular atrophy (IF/TA) in protocol biopsy at 36 months. CMV DNAemia was stratified by viral load in whole blood. Results: A total of 180 patients transplanted from October 2003 through January 2011 were included and followed for 4 years; 87 (48%) patients received 3-month prophylaxis with valacyclovir and 45 (25%) with valganciclovir; 48 (27%) were managed by preemptive therapy. Within 12 months of transplantation, CMV DNAemia developed in 102 (57%) patients with 36 (20%) having a viral load of GREATER-THAN OR EQUAL TO2000 copies/ml. Multivariate Cox analysis identified CMV DNAemia as an independent risk factor for graft loss (hazard ratio 3.42, P=0.020); however, after stratification by viral load, only CMV DNAemia GREATER-THAN OR EQUAL TO2000 copies/ml (hazard ratio 7.62, P&lt;0.001) remained significant. Both early-onset (&lt;3 months, P=0.048) and late-onset (&gt;3 months, P&lt;0.001) CMV DNAemia GREATER-THAN OR EQUAL TO2000 copies/ml were risk factors for graft loss. The incidence of moderate-to-severe IF/TA was not significantly influenced by CMV DNAemia. Conclusions: Kidney transplant recipients having CMV DNAemia with a higher viral load irrespective of the time to onset are at increased risk for graft loss.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30217 - Urology and nephrology

Projekt

Výsledek vznikl pri realizaci vícero projektů. Více informací v záložce Projekty.

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)<br>I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Antiviral Therapy

ISSN

1359-6535

e-ISSN

—

Svazek periodika

22

Číslo periodika v rámci svazku

6

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

11

Strana od-do

503-513

Kód UT WoS článku

000425256000005

EID výsledku v databázi Scopus

2-s2.0-85026432621