{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T04:40:56Z","timestamp":1777869656551,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T00:00:00Z","timestamp":1704412800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cytomegalovirus (CMV) infections are a common complication after kidney transplantation (KTx) and negatively affecting patient outcome. Valganciclovir (VGC) prophylaxis is often limited by drug\u2010induced side effects and dose reduction due to decline in kidney function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In the present study, episodes of CMV viremia in the first year after KTx in a cohort of 316 recipients were analyzed retrospectively to identify risk factors linked to persistent infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the studied cohort, 18.7% of patients showed a high\u2010risk (HR) constellation (D+\/R\u2013) for CMV infections. CMV viremia affected 22% of our cohort, with HR patients being the most affected cohort (44.1%). Within this group, most viremic events (65.3%) occurred while patients were still on prophylactic therapy, showing significantly higher viral loads and a longer duration compared to seropositive recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The analysis at hand revealed that detection of viremia under ongoing antiviral prophylaxis bears an increased risk for sustained viral replication and antiviral drug resistance in HR patients. We identified low estimated glomerular filtration rate (eGFR) and lower dose VGC prophylaxis post\u2010KTx as a risk factor for breakthrough infections in HR patients in our single center cohort. These patients might benefit from a closer CMV monitoring or novel prophylactic agents as letermovir.\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tid14233-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14233","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T11:53:51Z","timestamp":1704455631000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Five\u2010year single\u2010center analysis of cytomegalovirus viremia in kidney transplant recipients and possible implication for novel prophylactic therapy approaches"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6696-9709","authenticated-orcid":false,"given":"Moritz","family":"Trappe","sequence":"first","affiliation":[{"name":"Department II of Internal Medicine and Center for Molecular Medicine Cologne University of Cologne Faculty of Medicine and University Hospital Cologne  Cologne Germany"},{"name":"Institute of Virology Medical Faculty and University Hospital Cologne University of Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3075-0473","authenticated-orcid":false,"given":"Patrick","family":"Affeldt","sequence":"additional","affiliation":[{"name":"Department II of Internal Medicine and Center for Molecular Medicine Cologne University of Cologne Faculty of Medicine and University Hospital Cologne  Cologne Germany"},{"name":"Laboratory of Experimental Immunology Institute of Virology Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Grundmann","sequence":"additional","affiliation":[{"name":"Department II of Internal Medicine and Center for Molecular Medicine Cologne University of Cologne Faculty of Medicine and University Hospital Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Kann","sequence":"additional","affiliation":[{"name":"Department II of Internal Medicine and Center for Molecular Medicine Cologne University of Cologne Faculty of Medicine and University Hospital Cologne  Cologne Germany"},{"name":"CECAD Research Center University of Cologne Faculty of Medicine and University Hospital Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix C.","family":"Koehler","sequence":"additional","affiliation":[{"name":"Department II of Internal Medicine and Center for Molecular Medicine Cologne University of Cologne Faculty of Medicine and University Hospital Cologne  Cologne Germany"},{"name":"CECAD Research Center University of Cologne Faculty of Medicine and University Hospital Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman\u2010Ulrich","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department II of Internal Medicine and Center for Molecular Medicine Cologne University of Cologne Faculty of Medicine and University Hospital Cologne  Cologne Germany"},{"name":"CECAD Research Center University of Cologne Faculty of Medicine and University Hospital Cologne  Cologne Germany"},{"name":"Center for Rare Diseases Cologne Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Stippel","sequence":"additional","affiliation":[{"name":"Department of General Visceral, Cancer and 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