title: Factors associated with the development of cytomegalovirus infection following solid organ transplantation.
abstract: BACKGROUND
  Infection with cytomegalovirus (CMV) remains a potentially serious complication in transplant patients. In this study we explored the risk factors for CMV infection in the 12 months following a solid organ transplantation (n = 242) in patients monitored for CMV infection from 2004 to 2007.
  
  
  METHODS
  CMV infection was defined as 2 consecutive quantifiable CMV-polymerase chain reaction (PCR) values or 1 measurement of >3000 copies/ml. Data describing pre- and post-transplantation variables were extracted from electronic health records. Time to CMV infection was investigated using Cox proportional hazards analysis.
  
  
  RESULTS
  Overall, 31% (75/242) of solid organ transplant patients developed CMV infection: 4/8 (50.0%) heart, 15/43 (34.9%) liver, 30/89 (33.7%) lung and 26/102 (25.5%) kidney transplant patients. The risk of CMV infection according to donor (D)/recipient (R) CMV serostatus (positive + or negative-) was highest for D+/R-(adjusted hazard ratio 2.6, 95% confidence interval 1.6-4.2) vs D+/R+, and was reduced for D-/R+(adjusted hazard ratio 0.2, 95% confidence interval 0.2-0.8) vs D+/R+.
  
  
  CONCLUSIONS
  Positive donor CMV-serostatus is a major risk factor for CMV-infection in CMV-na ve recipients, but also in recipients with positive CMV-serostatus. Conversely, if donor is CMV serostatus is negative, the risk of CMV infection is low, irrespective of recipients CMV-serostatus. These findings suggest poorer immune function towards donor-induced strains of CMV versus recipient own latent strains.
authors.affiliation: Copenhagen HIV Programme, University of Copenhagen, Faculty of Health Sciences, The Panum Institute/Building 21.1, Blegdamsvej 3B, 2200 Copenhagen N, Denmark. cdb@cphiv.dk
authors.forename: Caspar
authors.initials: C
authors.lastname: da Cunha-Bang
authors.forename: Søren S
authors.initials: SS
authors.lastname: Sørensen
authors.forename: Martin
authors.initials: M
authors.lastname: Iversen
authors.forename: Henrik
authors.initials: H
authors.lastname: Sengeløv
authors.forename: Jens G
authors.initials: JG
authors.lastname: Hillingsø
authors.forename: Allan
authors.initials: A
authors.lastname: Rasmussen
authors.forename: Svend A
authors.initials: SA
authors.lastname: Mortensen
authors.forename: Zoe V
authors.initials: ZV
authors.lastname: Fox
authors.forename: Nikolai S
authors.initials: NS
authors.lastname: Kirkby
authors.forename: Claus B
authors.initials: CB
authors.lastname: Christiansen
authors.forename: Jens D
authors.initials: JD
authors.lastname: Lundgren
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000276:immunology* / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000209:etiology / Q000276:immunology*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014019:Tissue Donors; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D015774:Ganciclovir