title: Utility of oral valganciclovir for cytomegalovirus prophylaxis: does it improve treatment compliance?
abstract: BACKGROUND
  Cytomegalovirus (CMV) infection is a significant cause of morbidity and mortality among heart transplant (HT) patients. Various prophylactic and preemptive treatment regimens have been used for its prevention. We sought to assess the impact of oral valganciclovir on CMV prophylaxis in HT patients.
  
  
  METHODS
  A retrospective analysis of 536 consecutive HT patients at our institution allowed selection of subjects eligible for prophylaxis based on CMV serology (donor positive/recipient negative). Treatment compliance, rates of preemptive therapy and treatment for CMV disease were assessed according to prophylactic drug use. If the indication was present, treatment was considered to have been performed.
  
  
  RESULTS
  Among 536 patients, 9.8% (n = 53) were eligible for prophylaxis. Seventeen patients (33%) received valganciclovir, with a compliance rate of 94.1%. The remaining 68% received prophylaxis mainly with IV. ganciclovir (5 mg/kg) during their hospital stay followed by oral ganciclovir, with a compliance rate of 57.1% (P = .01). No differences were observed when we analyzed the need for preemptive therapy (0 vs 7%; P = .28) or for treatment of systemic or organ-specific infection (6.3 vs 0%; 6.3 vs 14%, respectively; P = .8).
  
  
  CONCLUSIONS
  Oral valganciclovir facilitated treatment compliance in prophylaxis for CMV without being inferior to other prophylactic therapies.
authors.affiliation: Foundation for Research, Internal Medicine, La Fe University Hospital, Valencia, Spain; Heart Failure and Transplant Unit, Cardiology, Internal Medicine, La Fe University Hospital, Valencia, Spain. moro@uv.es
authors.forename: J A
authors.initials: JA
authors.lastname: Moro
authors.forename: L
authors.initials: L
authors.lastname: Almenar
authors.forename: L
authors.initials: L
authors.lastname: Martínez-Dolz
authors.forename: M
authors.initials: M
authors.lastname: Blanes
authors.forename: J
authors.initials: J
authors.lastname: Agüero
authors.forename: I
authors.initials: I
authors.lastname: Sánchez-Lázaro
authors.forename: A
authors.initials: A
authors.lastname: Salvador
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000517:prevention & control*; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D018579:Patient Selection; D012189:Retrospective Studies; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir