title: Low-Dose Valacyclovir for Cytomegalovirus Infection Prophylaxis After a Heart Transplant.
abstract: OBJECTIVE
  Cytomegalovirus infection is a major cause of morbidity and mortality in solid-organ transplant. Low doses of valacyclovir have been administered as cytomegalovirus prophylaxis in our institution for years. To the best of our knowledge, there is no published study of a low-dose regimen for cytomegalovirus prophylaxis in heart transplant patients. Therefore, our aim was to determine the results of low doses of valacyclovir in heart transplant.
  
  
  METHODS
  Between September 2006 and December 2014, sixty-eight patients underwent orthotopic heart transplants. All of the patients received triple immunosuppressive therapy after surgery. During the next 6 months, sulfamethoxazole/trimethoprim was administered for Pneumocystis jiroveci pneumonia, and toxoplasmosis. Additionally all patients received valacyclovir hydrochloride (1000 mg/d, oral) for cytomegalovirus prophylaxis and nystatin oral rinse for prophylaxis of fungal infections.
  
  
  RESULTS
  There was only 1 cytomegalovirus infection at follow-up. The patient had cytomegalovirus pneumonia at 17-month follow-up. In response to treatment with 1-week intravenous ganciclovir, the patient was discharged with a further 6-month oral valacyclovir therapy (1000 mg/d).
  
  
  CONCLUSIONS
  In this study, we hypothesized that daily use of low-dose valacyclovir (1000 mg/d) is not only sufficient for cytomegalovirus prophylaxis but also beneficial in terms of cost.
authors.affiliation: From the Department of Cardiovascular Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Kervan
authors.forename: Seref Alp
authors.initials: SA
authors.lastname: Kucuker
authors.forename: Sinan Sabit
authors.initials: SS
authors.lastname: Kocabeyoglu
authors.forename: Ertekin Utku
authors.initials: EU
authors.lastname: Unal
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Ozatik
authors.forename: Dogan Emre
authors.initials: DE
authors.lastname: Sert
authors.forename: Kemal
authors.initials: K
authors.lastname: Kavasoglu
authors.forename: Ayse Yasemin
authors.initials: AY
authors.lastname: Tezer
authors.forename: Mustafa
authors.initials: M
authors.lastname: Pac
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003587:Cytomegalovirus / Q000187:drug effects* / Q000276:immunology / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D011024:Pneumonia, Viral / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D000077483:Valacyclovir; D014633:Valine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D014775:Virus Activation / Q000187:drug effects; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D014633:Valine; D000077483:Valacyclovir; D000212:Acyclovir