[Efficacy preemptive therapy with ganciclovir for the prevention of cytomegalovirus disease in liver transplant recipients].
OBJECTIVE
In liver transplant recipients the most frequent infection is that produced by cytomegalovirus (CMV). One of the methods to reduce the incidence of that infection is the CMV pp65 antigenemia-guided preemptive therapy with intravenous ganciclovir.


METHODS
Liver transplant recipients were tested for CMV antigenemia at days 14, 28, 45, 60, 90 and 180 postransplantation and when clinically indicated. Patients showing > 50/200.000 leukocytes received ganciclovir 5 mg/kg/12 h for 14 days. Risk factors for active CMV disease where studied.


RESULTS
182 CMV seropositive patients where included in the study. 16 patients with > 50/200.000 leukocytes received ganciclovir as preemptive therapy. CMV disease appeared in 9/182 patients (4.9%): 2/16 who received PT and 7/166 among those who did not receive preemptive therapy. The only factor associated with increased incidence of CMV disease was to have missing samples for CMV antigenemia during the follow up (p < 0.0042; OR = 8,17; 95% CI, 1.94-34.36).


CONCLUSIONS
Ganciclovir antigenemia-guided preemptive therapy is associated with a low incidence of CMV disease. Bad adherence to the protocol of antigenemia samples increases the risk for CMV disease.
López-Medrano
Francisco
F
Unidad de Enfermedades Infecciosas. Hospital Universitario 12 de Octubre. Madrid. Spain.
Lumbreras
Carlos
C
Otero
Joaquín R
JR
González-Alegre
M Teresa
MT
San Juan
Rafael
R
Folgueira
Dolores
D
Lizasoaín
Manuel
M
Loinaz
Carmelo
C
Moreno
Enrique
E
Aguado
José María
JM
D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors
D000956:Antigens, Viral; D000998:Antiviral Agents; D015774:Ganciclovir