title: The impact of prophylactic antiviral agents and statin administration on graft longevity in kidney allograft recipients.
abstract: BACKGROUND
  In an earlier study, we compared the duration of kidney graft survival between two groups of recipients; one on triple (cyclosporine, prednisone and mycophenolate mofetil) and the other on quadruple (cyclosporine, prednisone, mycophenolate mofetil, and sirolimus) immunosuppressive therapy.
  
  
  OBJECTIVE
  The aim of this study was to examine the impact of antiviral and statin therapy on graft longevity.
  
  
  METHODS
  One hundred five kidney allograft recipients were preoperatively assessed for serological markers of infection with various viral agents. All patients were on a prophylactic antiviral regimen of acyclovir and gancyclovir. Seventeen patients were on a statin. Patients were monitored for viral infections and graft rejection or loss for period of 3 years posttransplantation.
  
  
  RESULTS
  We detected a high preoperative prevalence rate of IgG immunoglobulins versus the latency-establishing Herpesviridae viruses. Two patients who were preoperatively IgG positive for CMV had cytomegalovirus disease after transplantation. One patient who was preoperatively IgG positive for VZV had shingles after the surgery. No other confirmed viral infections were reported. Thirteen of 88 patients (14.77%) whose treatment regimen did not include a statin suffered a rejection episode or lost the graft whereas 1 of 17 patients (5.88%) on a statin had a rejection episode.
  
  
  CONCLUSIONS
  The low rate of viral infections observed in our study population supports the utility of prophylactic administration of antiviral agents to transplant recipients. However, statins seem to have a protective effect on graft longevity (odds ratio [OR] = 0.361, 95% confidence interval [CI] = 0.044-2.957).
authors.affiliation: Department of Microbiology and Immunology, Beirut, Lebanon. er00@aub.edu.lb
authors.forename: Elias A
authors.initials: EA
authors.lastname: Rahal
authors.forename: Marita
authors.initials: M
authors.lastname: Chakhtoura
authors.forename: Rana Abu
authors.initials: RA
authors.lastname: Dargham
authors.forename: Raja B
authors.initials: RB
authors.lastname: Khauli
authors.forename: Walid
authors.initials: W
authors.lastname: Medawar
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Abdelnoor
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000998:Antiviral Agents / Q000008:administration & dosage*; D016572:Cyclosporine / Q000008:administration & dosage; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000517:prevention & control; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy* / Q000821:virology; D006085:Graft Survival / Q000187:drug effects*; D006562:Herpes Zoster / Q000517:prevention & control; D014645:Herpesvirus 3, Human; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D011239:Prednisolone / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage; D014184:Transplantation, Homologous
chemical_list: D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D009173:Mycophenolic Acid; D020123:Sirolimus