Cytomegalovirus Infection Among Adult Kidney Transplant Recipients: Findings From the USRDS-medicare Linked Database Study
A. Raval1, M. Ganz2, S. Alam2, Y. Tang1, C. Santos3
1Merck & Co., Inc., Rahway, NJ, 2Evidera-PPD, Waltham, MA, 3Rush University Medical Center, Chicago, IL
Meeting: 2021 American Transplant Congress
Abstract number: LB 68
Keywords: Cytomeglovirus, Infection, Kidney transplantation, Outcome
Topic: Clinical Science » Infectious Disease » Kidney Infectious Non-Polyoma & Non-Viral Hepatitis
Session Information
Session Name: Kidney Infectious Non-Polyoma & Non-Viral Hepatitis
Session Type: Poster Abstract
Session Date & Time: None. Available on demand.
Location: Virtual
*Purpose: Cytomegalovirus infection (CMVi) is a frequent complication and significant cause of morbidity and mortality after kidney transplantation (KT). However, there are limited recent national data on the incidence of CMVi among KT recipients (KTRs). We examined the incidence of CMV infection overall and stratified by donor (D) and recipients (R) CMV serostatus pairing among adults undergoing KT in the United States (US).
*Methods: A retrospective cohort design was utilized to examine the incidence of CMV infection among adult KTRs from the US Renal Data System Registry-Medicare linked data. Adults who received their first KT from July 1, 2011, through December 31, 2016, with continuous medical coverage for 6-month pre and 12-month post-KT were included. CMVi was considered as ≥ 1 medical claim with the International Classification of Disease, 9th Revision (ICD-9) codes of 078.5 or ICD-10 codes of B25.0, B25.1, B25.2, B25.8, B25.9, B27.1, H32.00, K87.00, K93.820 within 12-month post-KT. CMV antiviral (AV) prophylaxis was identified as ≥ 1 fill for (val)ganciclovir or (val) acyclovir within 28 days post-KT. Descriptive statistics were reported on the frequency and incidence of rates of CMVi for the study cohort and by D/R pairing/groups.
*Results: The study cohort included 23,445 KTRs of whom 15%, 74%, and 11% had D+/R-, R+ and D-/R- CMV serostatus pairing groups, respectively. Overall, 77% received CMV AV prophylaxis, and 10% had CMVi within 12-month post-KT. KTRs with D+/R- CMV serostatus pairing had higher rates of CMVi (20%) compared to KTTs with R+ (9%) and D-/R- (2%) groups (see Table 1). The average time to first CMVi event was longer among KTRs with D+/R- in comparison to R+ or D-/R- group, and frequency of CMVi post-200 days was higher among D+/R- group.
*Conclusions: Nearly one in ten KTRs had at least one medical claim for CMV infection. KTRs with D+/R- CMV serostatus pairing had a higher incidence rate of overall CMV infection and late infection post-200 days KT.
| CMV Outcome | Overall | D+/R- | R+ | D-/R- |
| Sample Size, n | 23445 | 3,582 | 17,398 | 2,465 |
| 1st CMV infection, n(%) | 2259 (9.6%) | 716 (20.0%) | 1,490 (8.6%) | 53 (2.2%) |
| Time to 1st CMV infection post KT, in days, mean (SD) | 125.6 (102.2) | 165.9 (96.0) | 107.4 (99.8) | 94.2 (92.4) |
| 1st CMV infection: 0-100 days post-KT 0-100 days, n(%) | 1041 (46.0%) | 211 (29.4%) | 795 (53.3%) | 35 (66.0%) |
| 1st CMV infection: 100-200 days post-KT, n(%) | 625 (27.7%) | 219 (30.6%) | 397 (26.6%) | 9 (16.9%) |
| 1st CMV infection: 200+ days post-KT, n(%) | 593 (26.3%) | 286 (39.9%) | 298 (20.0%) | 9 (16.9%) |
|
Incidence Rate for CMV infection, in Person-Years IR (95% CI) |
10.43 (10.01 – 10.87) | 22.83 (21.19 – 24.56) | 9.24 (8.78 – 9.72) | 2.22 (1.66 – 2.90) |
To cite this abstract in AMA style:
Raval A, Ganz M, Alam S, Tang Y, Santos C. Cytomegalovirus Infection Among Adult Kidney Transplant Recipients: Findings From the USRDS-medicare Linked Database Study [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/cytomegalovirus-infection-among-adult-kidney-transplant-recipients-findings-from-the-usrds-medicare-linked-database-study/. Accessed November 21, 2024.« Back to 2021 American Transplant Congress