title: Low-dose valganciclovir for cytomegalovirus prophylaxis in heart transplant recipients.
abstract: We retrospectively assessed our center's experience with a protocol of low-dose (450 mg once daily) valganciclovir administered for 3-6 months (median 5 months) in a cohort of of 55 cytomegalovirus (CMV) donor-positive (D+) and/or recipient-positive (R+) heart transplant recipients. Although no CMV disease occurred in patients while receiving low-dose valganciclovir, during the 12-month post-transplantation observation period of this study, 4 (22.2%) of the 18 D+/R- patients and 1 (2.7%) of the 37 R+ patients developed symptomatic CMV viremia. Leukopenia was frequent, including neutropenia [absolute neutrophil count (ANC), <1,000 cells/μL] that occurred in 21.8% and severe neutropenia (ANC <500 cells/μL) in 7.3%. Among CMV R+ heart transplant recipients, low-dose valganciclovir appeared to be an effective, less expensive strategy for CMV prophylaxis; however, caution may be necessary among D+/R- recipients.
authors.affiliation: Division of Infectious Diseases, Penn State Hershey Medical Center, Hershey, Pennsylvania. Electronic address: kjulian@hmc.psu.edu.
authors.forename: K G
authors.initials: KG
authors.lastname: Julian
authors.forename: E
authors.initials: E
authors.lastname: Shattahi
authors.forename: J E
authors.initials: JE
authors.lastname: Burg
authors.forename: J P
authors.initials: JP
authors.lastname: Boehmer
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003586:Cytomegalovirus Infections / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D015774:Ganciclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016027:Heart Transplantation; D006801:Humans; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir