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dr Firman Abdullah SpOG / OBGYN

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Tuesday, April 21, 2009

Late-onset CMV disease following CMV prophylaxis


JournalIrish Journal of Medical Science
PublisherSpringer London
ISSN0021-1265 (Print) 1863-4362 (Online)
IssueVolume 178, Number 3 / September, 2009
CategoryBrief Report
DOI10.1007/s11845-009-0327-3
Pages333-336
Subject CollectionMedicine
SpringerLink DateThursday, April 02, 2009

C. Donnelly1 Contact Information, F. Kennedy1 Contact Information, C. Keane1, K. Schaffer2 and P. A. McCormick3

(1) Pharmacy Department, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
(2) Microbiology Department, St. Vincent’s University Hospital and University College Dublin, Dublin 4, Ireland
(3) National Liver Transplant Unit, St. Vincent’s University Hospital and University College Dublin, Dublin 4, Ireland

Received: 8 December 2008 Accepted: 9 March 2009 Published online: 2 April 2009

Abstract
Background Cytomegalovirus (CMV) is the most common opportunistic infection after solid-organ transplantation, increasing morbidity and mortality. Three months of oral valganciclovir have been shown to provide effective prophylaxis. Late-onset CMV disease, occurring after the discontinuation of prophylaxis, is now increasingly recognised.
Aims To investigate the incidence and the time of detection of CMV infections in liver transplant recipients who received CMV prophylaxis.
Methods Retrospective review of 64 high- and moderate-risk patients with 1 year of follow-up.
Results The incidence of CMV infection was 12.5%, with 4.7% disease. All cases of symptomatic CMV disease were of late-onset.
Conclusions The incidence of CMV infections in this study was low compared with literature reports; however, the late-onset disease is an emerging problem. Detection of late-onset disease may be delayed because of less frequent clinic follow-up visits. Increased regular laboratory monitoring may allow earlier detection at the asymptomatic infection stage.

Keywords Cytomegalovirus - Liver transplant - Valganciclovir - Ganciclovir - Cytomegalovirus prophylaxis - Late-onset cytomegalovirus

This research was undertaken as part of an MSc in Hospital Pharmacy, awarded by Trinity College Dublin.

Contact InformationC. Donnelly
Email: c.donnelly@st-vincents.ie

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