(Val-)Ganciclovir prophylaxis reduces Epstein-Barr virus primary infection in pediatric renal transplantation.
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(Val-)Ganciclovir prophylaxis reduces Epstein-Barr virus primary infection in pediatric renal transplantation. / Höcker, Britta; Böhm, Stephan; Fickenscher, Helmut; Küsters, Uta; Schnitzler, Paul; Pohl, Martin; John, Ulrike; Kemper, Markus J.; Fehrenbach, Henry; Wigger, Marianne; Holder, Martin; Schröder, Monika; Feneberg, Reinhard; Köpf-Shakib, Sabine; Tönshoff, Burkhard.
in: TRANSPL INT, Jahrgang 25, Nr. 7, 7, 2012, S. 723-731.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - (Val-)Ganciclovir prophylaxis reduces Epstein-Barr virus primary infection in pediatric renal transplantation.
AU - Höcker, Britta
AU - Böhm, Stephan
AU - Fickenscher, Helmut
AU - Küsters, Uta
AU - Schnitzler, Paul
AU - Pohl, Martin
AU - John, Ulrike
AU - Kemper, Markus J.
AU - Fehrenbach, Henry
AU - Wigger, Marianne
AU - Holder, Martin
AU - Schröder, Monika
AU - Feneberg, Reinhard
AU - Köpf-Shakib, Sabine
AU - Tönshoff, Burkhard
PY - 2012
Y1 - 2012
N2 - Epstein-Barr virus (EBV) primary infection constitutes a serious risk for pediatric transplant recipients, particularly as regards the development of EBV-related post-transplant lymphoproliferative disease (PTLD). Currently, there is no established prophylactic regimen. We investigated the association between chemoprophylaxis with valganciclovir (VGCV) or ganciclovir (GCV) and the incidence of EBV viremia in EBV-naïve pediatric renal transplant recipients (R-) who had received a graft from an EBV-positive donor (D+) and are therefore at high risk of EBV primary infection. In a prospective, multicenter trial (n = 114), we compared a cohort on chemoprophylaxis (n = 20) with a similar control cohort without chemoprophylaxis (n = 8). Over the 1-year study period, antiviral prophylaxis with VGCV/GCV was associated with a significantly decreased incidence of EBV primary infection: 9/20 patients (45%) in the prophylaxis group experienced an EBV primary infection compared to 8/8 controls (100%) (P < 0.0001). Chemoprophylaxis was associated with a significantly lower EBV viral load (P < 0.001). Type or intensity of immunosuppressive therapy did not influence the occurrence of EBV primary infection or the level/persistence of EBV viral load. Chemoprophylaxis with VGCV/GCV is associated with a reduced incidence of EBV viremia in high-risk pediatric kidney allograft recipients in the first year post-transplant. (ClinicalTrials.gov number: NCT00963248).
AB - Epstein-Barr virus (EBV) primary infection constitutes a serious risk for pediatric transplant recipients, particularly as regards the development of EBV-related post-transplant lymphoproliferative disease (PTLD). Currently, there is no established prophylactic regimen. We investigated the association between chemoprophylaxis with valganciclovir (VGCV) or ganciclovir (GCV) and the incidence of EBV viremia in EBV-naïve pediatric renal transplant recipients (R-) who had received a graft from an EBV-positive donor (D+) and are therefore at high risk of EBV primary infection. In a prospective, multicenter trial (n = 114), we compared a cohort on chemoprophylaxis (n = 20) with a similar control cohort without chemoprophylaxis (n = 8). Over the 1-year study period, antiviral prophylaxis with VGCV/GCV was associated with a significantly decreased incidence of EBV primary infection: 9/20 patients (45%) in the prophylaxis group experienced an EBV primary infection compared to 8/8 controls (100%) (P < 0.0001). Chemoprophylaxis was associated with a significantly lower EBV viral load (P < 0.001). Type or intensity of immunosuppressive therapy did not influence the occurrence of EBV primary infection or the level/persistence of EBV viral load. Chemoprophylaxis with VGCV/GCV is associated with a reduced incidence of EBV viremia in high-risk pediatric kidney allograft recipients in the first year post-transplant. (ClinicalTrials.gov number: NCT00963248).
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Prospective Studies
KW - Cohort Studies
KW - Child
KW - Kidney Transplantation/methods
KW - Immunosuppressive Agents/therapeutic use
KW - Antiviral Agents/therapeutic use
KW - Chemoprevention/methods
KW - Epstein-Barr Virus Infections/prevention & control
KW - Ganciclovir/analogs & derivatives/therapeutic use
KW - Herpesvirus 4, Human/metabolism
KW - Lymphoproliferative Disorders/etiology
KW - Pediatrics/methods
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Prospective Studies
KW - Cohort Studies
KW - Child
KW - Kidney Transplantation/methods
KW - Immunosuppressive Agents/therapeutic use
KW - Antiviral Agents/therapeutic use
KW - Chemoprevention/methods
KW - Epstein-Barr Virus Infections/prevention & control
KW - Ganciclovir/analogs & derivatives/therapeutic use
KW - Herpesvirus 4, Human/metabolism
KW - Lymphoproliferative Disorders/etiology
KW - Pediatrics/methods
M3 - SCORING: Journal article
VL - 25
SP - 723
EP - 731
JO - TRANSPL INT
JF - TRANSPL INT
SN - 0934-0874
IS - 7
M1 - 7
ER -
