Does mycophenolate mofetil increase the risk of cytomegalovirus infection in solid organ transplant recipients?--A mini-review.
Mycophenolate mofetil (MMF) is currently used for prophylaxis of acute rejection in solid organ transplantation. There have been diverging reports regarding an association between MMF and the risk of cytomegalovirus (CMV) infection. We reviewed the main published studies in an attempt to clarify the association between the use of MMF and the risk, frequency and severity of CMV infections. In a search of the Medline database with the terms "mycophenolate" and "cytomegalovir*", 42 articles were found to be relevant; among these, 29 articles were thoroughly analyzed. The first studies on MMF in renal transplantation already showed a tendency towards an association between this drug and the occurrence of CMV disease. Further studies were designed specifically to study this association; with the conclusion that an immunosuppressive regimen containing MMF increases the likelihood of CMV disease. Most studies were performed with kidney transplant recipients. We conclude that the use of MMF apparently increases the incidence of CMV disease in renal transplant patients; however, further studies are needed to confirm this association.
Song
Alice Tung Wan
AT
Department of Infectious and Parasitic Diseases, University of São Paulo Medical School; São Paulo, SP, Brazil.
Abdala
Edson
E
Bonazzi
Patrícia Rodrigues
PR
Bacchella
Telésforo
T
Machado
Marcel Cerqueira César
MC
D003586:Cytomegalovirus Infections / Q000139:chemically induced* / Q000453:epidemiology; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D015994:Incidence; D016030:Kidney Transplantation; D016031:Liver Transplantation; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D012307:Risk Factors; D012720:Severity of Illness Index
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid