title: Prevalence and risk factors of recurrent cytomegalovirus infection in kidney transplant recipients.
abstract: BACKGROUND
  Recurrence of cytomegalovirus (CMV) infection following solid organ transplantation causes mortality and morbidity in allograft recipients. The aim of this study was to evaluate prevalence and risk factors of recurrent CMV infection in kidney transplant patients.
  
  
  METHODS
  Four hundred and twenty-seven consecutive kidney transplant recipients were included in this retrospective cohort study. Both donors and recipients were CMV seropositive. Recurrent CMV infection (symptomatic or asymptomatic) was defined as detection of CMV infection in a patient who has had previously documented infection and who had not have virus detected for an interval of at least 4 weeks during active surveillance.
  
  
  RESULTS
  Of 427 recipients, 71 (16.6%) had CMV infection, of which 19 (4.4%) were recurrent infection. Donor source, dialysis duration before transplantation, recipient and donor age and sex, and administration of antithymocyte globulin and prophylactic treatment ganciclovir were not associated with CMV infection or recurrence. The use of tacrolimus in the immunosuppressive regimen as compared to cyclosporine was an independent risk factor for CMV infection but not recurrent infection.
  
  
  CONCLUSIONS
  Intensive immunosuppressive regimen, such as using tacrolimus, might be associated with a higher risk for CMV infection, but this study was not able to document the same association for recurrent CMV disease. In patients receiving immunosuppressive regimens that include tacrolimus and antithymocyte globulin, prophylactic treatment for CMV disease with ganciclovir is recommended.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Nafar
authors.affiliation: Department of Internal Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. shivaroshana@yahoo.com.
authors.forename: Azamosadat
authors.initials: A
authors.lastname: Roshan
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Pour-Reza-Gholi
authors.forename: Fariba
authors.initials: F
authors.lastname: Samadian
authors.forename: Pedram
authors.initials: P
authors.lastname: Ahmadpoor
authors.forename: Shiva
authors.initials: S
authors.lastname: Samavat
authors.forename: Mohammad Amin
authors.initials: MA
authors.lastname: Abbasi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000961:Antilymphocyte Serum / Q000009:adverse effects; D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods; D016559:Tacrolimus / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D015774:Ganciclovir; D016559:Tacrolimus