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 September 15, 2019.
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