title: Two-year post-transplantation cytomegalovirus DNAemia in asymptomatic kidney transplant recipients: incidence, risk factors, and outcome.
abstract: BACKGROUND
  The incidence and the impact of asymptomatic cytomegalovirus (CMV) DNAemia occurring after the first year post transplantation is unknown.
  
  
  METHODS
  In this retrospective cross-sectional study, we analyzed the incidence, risk factors, and impact of 2-year post-transplantation asymptomatic CMV DNAemia (2YCD) on graft function. We included 892 consecutive asymptomatic kidney transplant recipients transplanted for at least 2 years and all were monitored using whole blood CMV quantitative nucleic acid amplification testing (CMV-QNAT).
  
  
  RESULTS
  Twenty-eight patients displayed 2YCD (3.1%). Using multivariate analysis in 578 patients, we found that female gender (odds ratio [OR] = 2.57, P = 0.02), a past history of CMV drug-resistance mutation (OR = 8.73, P = 0.005), and corticosteroid use (OR = 2.37, P = 0.03) were independently associated with an increased risk of 2YCD. 2YCD was associated with an increased incidence of subsequent CMV disease over the year following its diagnosis (7% vs. 0.6%, P = 0.02). Patients with 2YCD also exhibited a declining estimated glomerular filtration rate more frequently (77%) than patients with a negative CMV-QNAT (56%, P = 0.02).
  
  
  CONCLUSIONS
  2YCD appears to be a rare entity, which appears to be associated with chronic graft dysfunction.
authors.affiliation: Service de Néphrologie-Transplantation-Dialyse, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France.|Université de Bordeaux, Bordeaux, France.
authors.forename: B
authors.initials: B
authors.lastname: Viot
authors.affiliation: Université de Bordeaux, Bordeaux, France.|Laboratoire de Virologie, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France.|Microbiologie Fondamentale et Pathogénicité, Unité Mixte de Recherche (UMR) 5234, Bordeaux, France.
authors.forename: I
authors.initials: I
authors.lastname: Garrigue
authors.affiliation: Service de Néphrologie-Transplantation-Dialyse, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France.|Université de Bordeaux, Bordeaux, France.
authors.forename: B
authors.initials: B
authors.lastname: Taton
authors.affiliation: Service de Néphrologie-Transplantation-Dialyse, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France.|Université de Bordeaux, Bordeaux, France.|Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID, Bordeaux, France.
authors.forename: T
authors.initials: T
authors.lastname: Bachelet
authors.affiliation: Université de Bordeaux, Bordeaux, France.|Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID, Bordeaux, France.
authors.forename: J-F
authors.initials: JF
authors.lastname: Moreau
authors.affiliation: Université de Bordeaux, Bordeaux, France.|Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID, Bordeaux, France.
authors.forename: J
authors.initials: J
authors.lastname: Dechanet-Merville
authors.affiliation: Service de Néphrologie-Transplantation-Dialyse, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France.|Université de Bordeaux, Bordeaux, France.|Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID, Bordeaux, France.
authors.forename: P
authors.initials: P
authors.lastname: Merville
authors.affiliation: Service de Néphrologie-Transplantation-Dialyse, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France.|Université de Bordeaux, Bordeaux, France.|Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID, Bordeaux, France.
authors.forename: L
authors.initials: L
authors.lastname: Couzi
mesh_terms: D000368:Aged; D058345:Asymptomatic Infections / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
keywords: CMV drug-resistance mutation; chronic graft dysfunction; corticosteroid; cytomegalovirus infection; kidney transplantation