title: Cytomegalovirus infection following renal transplantation in patients administered low-dose rituximab induction therapy.
abstract: Anti-CD20 antibody (rituximab) is recently being used as a B cell-depleting agent in renal transplantation (RTx). However, the incidence of infectious complications associated with rituximab therapy remains uncertain. We evaluated the incidence of cytomegalovirus (CMV) infection associated with rituximab therapy in RTx. A total of 83 patients were enrolled. The immunosuppressive regimen consisted of tacrolimus or cyclosporin, mycophenolate mofetil, methylprednisolone and basiliximab. In 54 patients, only one dose of rituximab (200 or 500 mg/kg body weight) was given before RTx. A total of 25 of 43 (58.1%) recipients who were CMV seropositive prior to RTx and who received rituximab induction therapy developed CMV infection, compared to 18 of 24 (75%) CMV seropositive recipients who did not receive rituximab therapy (P = 0.1676). A total of 8 of 11 patients who were CMV seronegative prior to RTx and who received rituximab developed CMV infection. However, CMV seroconversion was seen in all 8 of these infected patients. Low-dose rituximab induction therapy in renal transplant recipients appears to have no influence on the incidence of CMV infection and CMV seroconversion. However, we have to consider anti-CMV prophylaxis therapy, because of high incidents of CMV infection, especially for CMV seronegative recipients who received rituximab.
authors.affiliation: Department of Urology, Tokyo Women's Medical University, Tokyo, Japan. hnishida331@yahoo.co.jp
authors.forename: Hayato
authors.initials: H
authors.lastname: Nishida
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishida
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Amano
authors.forename: Kazuya
authors.initials: K
authors.lastname: Omoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirakawa
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Shimizu
authors.forename: Shoichi
authors.initials: S
authors.lastname: Iida
authors.forename: Daisuke
authors.initials: D
authors.lastname: Toki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000209:etiology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D000069283:Rituximab; D013156:Splenectomy / Q000009:adverse effects; D019172:Transplantation Conditioning / Q000009:adverse effects
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D000069283:Rituximab