Kinetics of Cytomegalovirus (CMV) DNAemia in CMV Mismatch Solid Organ Transplant Patients with Primary CMV Infection.
Medicine, University of Alberta, Edmonton, Canada
Meeting: 2017 American Transplant Congress
Abstract number: A277
Keywords: Cytomeglovirus, Infection
Session Information
Session Name: Poster Session A: Viral Conundrums
Session Type: Poster Session
Date: Saturday, April 29, 2017
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Despite antiviral prophylaxis, CMV infection is common in CMV mismatch (D+/R-) patients. We aimed to study the kinetics of CMV viral load in primary CMV infection and its influence on CMV reactivation.
We performed a retrospective study (Oct 2005-Dec 2011), including CMV D+/R- transplant patients at the University of Alberta Hospital. All patients received at least three months of antiviral prophylaxis. CMV infection (PI) was defined as an episode of CMV-DNAemia equal or higher than 1,000 IU/mL in the first year post-transplant. CMV reactivation was defined as CMV infection detected within 90 days after clearance of primary infection.
Out of 231 CMV D+/R- patients, 124 (54%) had CMV primary infection after a median interval of 170 days post-transplant (IQR 135.5 – 253.8) (Table 1). CMV reactivation was seen in 53% of lung transplant patients and 27% of non-lung recipients. Peak viral load and area under the curve (AUC) of viral load was different among different types of transplant (p=0.094 and p=0.038, respectively). The median duration of viremia was similar between transplant groups (p=0.574). No association was found between peak viral load and AUC with CMV reactivation.
| Table 1:Characteristics of CMV DNAemia kinetics in CMV primary infection.
*3 heart-lungs. ** 8 Simultaneous Pancreas- Kidney and 1 Pancreas. PI: CMV primary infection. AUC: area under curve. |
|||||
| Heart (n=25) | Kidney (n=80) | Liver (n=68) | Lung * (n=48) | SPK ** (n=9) | |
| Male sex (%) | 21 (84) | 59 (74) | 48 (71) | 29 (59) | 6 (67) |
| Mean age (years) | 48.8 | 50.4 | 53.1 | 52.9 | 42.0 |
| CMV PI (%) | 11 (44) | 37 (46) | 36 (53) | 34 (69) | 6 (67) |
| PI; median days after SOT | 150 | 168 | 146 | 245 | 161 |
| PI; first VL (median) | 3,476 | 4,600 | 1,506 | 1,925 | 21,735 |
| PI; median peak viral load | 50,500 | 37,250 | 13,600 | 24,037 | 84,000 |
| PI; median duration, days | 29 | 27 | 25 | 28.5 | 28.5 |
| PI; median AUC | 822,090 | 421,187 | 163,478 | 235,770 | 1,196,525 |
| Recurrence (% of PI) | 4 (36) | 13 (35) | 7 (19) | 18 (53) | 0 |
CMV viral load kinetics in D+/R- patients with CMV infection varies according to the type of transplantation. We found no association between CMV kinetics in primary infection and the risk of secondary reactivation.
CITATION INFORMATION: Hernandez C, Chiang D, Fuentes S, Cervera C. Kinetics of Cytomegalovirus (CMV) DNAemia in CMV Mismatch Solid Organ Transplant Patients with Primary CMV Infection. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Hernandez C, Chiang D, Fuentes S, Cervera C. Kinetics of Cytomegalovirus (CMV) DNAemia in CMV Mismatch Solid Organ Transplant Patients with Primary CMV Infection. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/kinetics-of-cytomegalovirus-cmv-dnaemia-in-cmv-mismatch-solid-organ-transplant-patients-with-primary-cmv-infection/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress