Risk factors associated with cytomegalovirus infection in orthotopic liver transplant patients.
Our objective was to investigate the potential risk factors associated with cytomegalovirus (CMV) infection.


METHODS
From January 1999 to December 2001, 163 liver transplantations were performed in 154 patients. The study inclusion criteria were absence of retransplantation and survival of more than 6 months. One hundred fifteen patients met the inclusion criteria. We determined variables such as age, gender, and number of hemecomponents as well as serum IgG CMV status of donors and recipients. We recorded the immunosuppression used by each patient. CMV infection was detected by positive antigenemia.


RESULTS
Recipient mean age was 50 years. The etiology of cirrhosis was viral (n = 57; 49.6%), alcoholic (n = 20; 17.4%), virus and alcohol (n = 15; 13.0%), cryptogenic (n = 14; 12.2%), or other causes (n = 9; 7.8%). CMV infection was positive in 75 patients (65.8%). There was no relation between infection and age, gender, or CMV IgG donor recipient status, or the number of hemecomponent units. The risk was 3.8-fold higher for patients receiving a three-drug compared with a two-drug regimen. When cyclosporine was used instead of tacrolimus, the risk of CMV infection was 4.3-fold higher. Logistic regression analysis revealed cyclosporine (OD=5.8) and a three-drug regimen (OD=6.7) to have stronger associations with CMV infection.


CONCLUSIONS
The use of cyclosporine (OD=5.8) and a three-drug regimen (OD=6.7) are risk factors for CMV infection.
Hoppe
L
L
Santa Casa, Porto Alegre, FFFCMPA, Rua Uruguai 2001, 312/B Passo Fundo, Rio Grande do Sul, CEP 99010-112 Brazil. lisiahoppe@brturbo.com.br
Marroni
C A
CA
Bressane
R
R
Lago
L
L
Schiavo
F L
FL
Cigerza
G C
GC
Brandão
A B M
AB
Zanotelli
M L
ML
Cantisani
G P C
GP
D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000821:virology*; D012189:Retrospective Studies; D012307:Risk Factors
D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D016572:Cyclosporine