title: HCMV infection in renal transplant recipients: a retrospective cohort study.
abstract: Human Cytomegalovirus (HCMV) represents the most common viral complication affecting solid organ transplant recipients (SOTRs) and its management is still debated. This study analyzes the association between HCMV infection and renal transplant recipients' outcomes. From January 2008 through December 2009, 97 consecutive renal transplant recipients were retrospectively studied. HCMV disease prevention was pursued by pre-emptive therapy, reserving long-term prophylaxis for high-risk patients. A total of 32/97 patients (32.9%) developed HCMV positivity in blood for a cumulative estimated proportion at 3 months post-transplantation of 0.21. HCMV disease developed in 7 patients (7.2%), while 25 patients had asymptomatic infection (25.7%). No patient died from HCMV. HCMV disease, older graft age and post-transplant renal dysfunction were independent predictors of rejection while HCMV infection without disease was associated with a higher number of other complications. The use of basiliximab was independently associated with a reduced hazard of HCMV infection/ disease. In renal transplant recipients HCMV infection still represents a major issue influencing the outcome, not only because of the potential to develop the disease and its link to graft rejection, but also in terms of higher number of complications. The choice of different immunosuppressive strategies might be associated with HCMV replication.
authors.affiliation: Infectious Diseases Section, Department of Medical Biotechnologies, University Hospital, Siena, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Puttini
authors.forename: Mario
authors.initials: M
authors.lastname: Carmellini
authors.forename: Guido
authors.initials: G
authors.lastname: Garosi
authors.forename: Barbara
authors.initials: B
authors.lastname: Rossetti
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Riccio
authors.forename: Giacinta
authors.initials: G
authors.lastname: Tordini
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Cusi
authors.forename: Andrea
authors.initials: A
authors.lastname: De Luca
authors.forename: Giacomo
authors.initials: G
authors.lastname: Zanelli
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D000077552:Basiliximab; D003587:Cytomegalovirus / Q000302:isolation & purification / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000209:etiology* / Q000517:prevention & control / Q000821:virology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control / Q000821:virology; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D019737:Transplants / Q000821:virology
chemical_list: D000911:Antibodies, Monoclonal; D000998:Antiviral Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab