title: Decreased incidence of cytomegalovirus infection with sirolimus in a post hoc randomized, multicenter study in lung transplantation.
abstract: BACKGROUND
  Cytomegalovirus (CMV) is the most common opportunistic infection in lung transplantation. A recent multicenter, randomized trial (the AIRSAC study) comparing sirolimus to azathioprine in lung transplant recipients showed a decreased incidence of CMV events in the sirolimus cohort. To better characterize this relationship of decreased incidence of CMV events with sirolimus, we examined known risk factors and characteristics of CMV events from the AIRSAC database.
  
  
  METHODS
  The AIRSAC database included 181 lung transplant patients from 8 U.S.-based lung transplant centers that were randomized to sirolimus or azathioprine at 3 months post-transplantation. CMV incidence, prophylaxis, diagnosis and treatment data were all prospectively collected. Prophylaxis and treatment of CMV were at the discretion of each institution.
  
  
  RESULTS
  The overall incidence of any CMV event was decreased in the sirolimus arm when compared with the azathioprine arm at 1 year after lung transplantation (relative risk [RR] = 0.67, confidence interval [CI] 0.55 to 0.82, p < 0.01). This decreased incidence of CMV events with sirolimus remained significant after adjusting for confounding factors of CMV serostatus and CMV prophylaxis.
  
  
  CONCLUSIONS
  These data support results from other solid-organ transplantation studies and suggest further investigation of this agent in the treatment of lung transplant recipients at high risk for CMV events.
authors.affiliation: Department of Medicine, University of Chicago Medical Center, Chicago, Illinois 60611, USA.
authors.forename: Bijan
authors.initials: B
authors.lastname: Ghassemieh
authors.forename: Vivek N
authors.initials: VN
authors.lastname: Ahya
authors.forename: Maher A
authors.initials: MA
authors.lastname: Baz
authors.forename: Vincent G
authors.initials: VG
authors.lastname: Valentine
authors.forename: Selim M
authors.initials: SM
authors.lastname: Arcasoy
authors.forename: Robert B
authors.initials: RB
authors.lastname: Love
authors.forename: Harish
authors.initials: H
authors.lastname: Seethamraju
authors.forename: Charles G
authors.initials: CG
authors.lastname: Alex
authors.forename: Remzi
authors.initials: R
authors.lastname: Bag
authors.forename: Nilto C
authors.initials: NC
authors.lastname: DeOliveira
authors.forename: Wickii T
authors.initials: WT
authors.lastname: Vigneswaran
authors.forename: Jeff
authors.initials: J
authors.lastname: Charbeneau
authors.forename: Edward R
authors.initials: ER
authors.lastname: Garrity
authors.forename: Sangeeta M
authors.initials: SM
authors.lastname: Bhorade
mesh_terms: D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control*; D011446:Prospective Studies; D020123:Sirolimus / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus