Prediction of Recurrent Cytomegalovirus Disease After Treatment With Ganciclovir in Solid-Organ Transplant Recipients

Berg, A. P. van den; Son, Willem J. van; Haagsma, Elisabeth B.; Klompmaker, I. J.; Tegzess, Adam; Schirm, J; Dijkstra, Gerard; Giessen, M. van der; Slooff, Maarten J. H.

doi:10.1097/00007890-199304000-00031

Cited by 53 publications

(34 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found a virological recurrence rate of 30% that is in line with earlier reports ranging from 25% to 30% (11,(13)(14)(15)17,18 (13)(14)(15). (11,13,14,17,18 …”

Section: Safety and Adverse Eventssupporting

confidence: 93%

See 1 more Smart Citation

Long-Term Outcomes of CMV Disease Treatment with Valganciclovir Versus IV Ganciclovir in Solid Organ Transplant Recipients

Åsberg

Humar

Jardine

et al. 2009

American Journal of Transplantation

163

118

View full text Add to dashboard Cite

“…We found a virological recurrence rate of 30% that is in line with earlier reports ranging from 25% to 30% (11,(13)(14)(15)17,18 (13)(14)(15). (11,13,14,17,18 …”

Section: Safety and Adverse Eventssupporting

confidence: 93%

“…However, the long-term outcomes and predictors of recurrence after an episode of treated CMV disease need further investigation (11)(12)(13)(14)(15)(16)(17)(18). (11,15,17).…”

Section: Cytomegalovirus (Cmv) Disease Is a Common Clinical Infectionmentioning

confidence: 99%

Long-Term Outcomes of CMV Disease Treatment with Valganciclovir Versus IV Ganciclovir in Solid Organ Transplant Recipients

Åsberg

Humar

Jardine

et al. 2009

American Journal of Transplantation

163

118

View full text Add to dashboard Cite

“…We chose a treatment length of 21 days followed by a maintenance period of 28 days. In transplant recipients treated for CMV disease, the risk of recurrent CMV disease after treatment is estimated to be 25-30% (22,23). The most important predictor of disease recurrence after treatment of CMV disease is persistent viremia at the end of anti-viral therapy (14,24).…”

Section: Discussionmentioning

confidence: 99%

Oral Valganciclovir Is Noninferior to Intravenous Ganciclovir for the Treatment of Cytomegalovirus Disease in Solid Organ Transplant Recipients

Åsberg

Humar

Rollag

et al. 2007

American Journal of Transplantation

380

298

View full text Add to dashboard Cite

Intravenous ganciclovir is the standard treatment for cytomegalovirus disease in solid organ transplant recipients. Oral valganciclovir is a more convenient alternative. In a randomized, international trial, recipients with cytomegalovirus disease were treated with either 900 mg oral valganciclovir or 5 mg/kg i. Oral valganciclovir shows comparable safety and is not inferior to i.v. ganciclovir for treatment of cytomegalovirus disease in organ transplant recipients and provides a simpler treatment strategy, but care should be taken in extrapolating to organ transplant recipients not properly represented in the present study.

show abstract

“…However, in some cases, the viral load may rise during the first few days to up to 2 weeks of antiviral treatment (200). This intermittent rise or fluctuations in some patients are often benign and will be followed eventually by a satisfactory decline in viral load over ensuing weeks (this pattern has also been observed with antigenemia testing).…”

Section: Treatment Responsementioning

confidence: 96%

Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

2013

View full text Add to dashboard Cite

SUMMARY The negative impact of cytomegalovirus (CMV) infection on transplant outcomes warrants efforts toward improving its prevention, diagnosis, and treatment. During the last 2 decades, significant breakthroughs in diagnostic virology have facilitated remarkable improvements in CMV disease management. During this period, CMV nucleic acid amplification testing (NAT) evolved to become one of the most commonly performed tests in clinical virology laboratories. NAT provides a means for rapid and sensitive diagnosis of CMV infection in transplant recipients. Viral quantification also introduced several principles of CMV disease management. Specifically, viral load has been utilized (i) for prognostication of CMV disease, (ii) to guide preemptive therapy, (iii) to assess the efficacy of antiviral treatment, (iv) to guide the duration of treatment, and (v) to indicate the risk of clinical relapse or antiviral drug resistance. However, there remain important limitations that require further optimization, including the interassay variability in viral load reporting, which has limited the generation of standardized viral load thresholds for various clinical indications. The recent introduction of an international reference standard should advance the major goal of uniform viral load reporting and interpretation. However, it has also become apparent that other aspects of NAT should be standardized, including sample selection, nucleic acid extraction, amplification, detection, and calibration, among others. This review article synthesizes the vast amount of information on CMV NAT and provides a timely review of the clinical utility of viral load testing in the management of CMV in solid organ transplant recipients. Current limitations are highlighted, and avenues for further research are suggested to optimize the clinical application of NAT in the management of CMV after transplantation.

show abstract

Prediction of Recurrent Cytomegalovirus Disease After Treatment With Ganciclovir in Solid-Organ Transplant Recipients

Cited by 53 publications

References 0 publications

Long-Term Outcomes of CMV Disease Treatment with Valganciclovir Versus IV Ganciclovir in Solid Organ Transplant Recipients

Long-Term Outcomes of CMV Disease Treatment with Valganciclovir Versus IV Ganciclovir in Solid Organ Transplant Recipients

Oral Valganciclovir Is Noninferior to Intravenous Ganciclovir for the Treatment of Cytomegalovirus Disease in Solid Organ Transplant Recipients

Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

Contact Info

Product

Resources

About