{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:31:45Z","timestamp":1791959505364,"version":"4.3.4"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,7,2]],"date-time":"2018-07-02T00:00:00Z","timestamp":1530489600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2018,10]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Anti\u2010thymocyte globulin (ATG<\/jats:styled-content>) therapy is a risk factor for cytomegalovirus (CMV<\/jats:styled-content>) disease in renal transplant (RT<\/jats:styled-content>x) recipients and therefore antiviral prophylaxis is commonly used. We evaluated the outcome of our current policy of 90\u00a0days of CMV<\/jats:styled-content> prophylaxis in seropositive recipients given ATG<\/jats:styled-content> and the risk factors for the occurrence of CMV<\/jats:styled-content> disease after prophylaxis.<\/jats:p><\/jats:sec>Methods<\/jats:title>We studied a retrospective cohort of 423 RT<\/jats:styled-content>x (2010\u20102014) CMV<\/jats:styled-content>\u2010seropositive adults given ATG<\/jats:styled-content> induction therapy.<\/jats:p><\/jats:sec>Results<\/jats:title>54 (13%) patients developed CMV<\/jats:styled-content> disease at a median of 163\u00a0days after transplant, of which 29 (54%) had viral syndrome and 25 (46%) had invasive disease. Median prophylaxis time (94\u00a0days) and immunosuppressive drugs were similar between groups (CMV<\/jats:styled-content> vs no\u2010CMV<\/jats:styled-content>). Those with CMV<\/jats:styled-content> disease had more deceased donors and higher donor age, lower lymphocyte count, and lower median eGFR<\/jats:styled-content> at day 90. Multivariable logistic regression analysis at day 90 and 180 found that eGFR<\/jats:styled-content> \u226440\u00a0ml\/min\/1.73\u00a0m2<\/jats:sup> (but not acute rejection) was associated with late CMV<\/jats:styled-content> disease. In a separate validation cohort of 124 patients with 8% late CMV<\/jats:styled-content> disease, eGFR<\/jats:styled-content> \u226445 and lymphocyte count \u2264800\u00a0cells\/mm3<\/jats:sup> at the end of prophylaxis remained predictive of late CMV<\/jats:styled-content> disease occurrence.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>These data indicate that antiviral prophylaxis adequately prevented CMV<\/jats:styled-content> in seropositive recipients given ATG<\/jats:styled-content>, but late disease still occurred. Low eGFR<\/jats:styled-content> and low lymphocyte count at the end of prophylaxis may help identify patients at higher risk of CMV<\/jats:styled-content> disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12929","type":"journal-article","created":{"date-parts":[[2018,5,29]],"date-time":"2018-05-29T20:45:21Z","timestamp":1527626721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Cytomegalovirus prophylaxis in seropositive renal transplant recipients receiving thymoglobulin induction therapy: Outcome and risk factors for late CMV<\/scp> disease"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9860-5339","authenticated-orcid":false,"suffix":"Jr","given":"Jose O.","family":"Reusing","sequence":"first","affiliation":[{"name":"Renal Transplantation Service Hospital das Cl\u00ednicas University of Sao Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanoela B.","family":"Feitosa","sequence":"additional","affiliation":[{"name":"Renal Transplantation Service Hospital das Cl\u00ednicas University of Sao Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Agena","sequence":"additional","affiliation":[{"name":"Renal Transplantation Service Hospital das Cl\u00ednicas University of Sao Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00edgia C.","family":"Pierrotti","sequence":"additional","affiliation":[{"name":"Renal Transplantation Service Hospital das Cl\u00ednicas University of Sao Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz S. 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