{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:18:47Z","timestamp":1792793927398,"version":"4.5.0"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K08\u2010AI163462"],"award-info":[{"award-number":["K08\u2010AI163462"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Belatacept is a costimulatory blocker that can be used to prevent and treat rejection in lung transplant recipients (LuTRs). The epidemiology of infections in belatacept\u2010treated LuTRs has not been systematically evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a single\u2010center retrospective study of all adult LuTRs who received belatacept as prevention or treatment of antibody\u2010mediated rejection (desensitization) or as part of maintenance immunosuppression from January 1, 2011, to June 30, 2022. We assessed the epidemiology of infections that occurred within 12 months following the first belatacept dose.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two LuTRs received at least one dose of belatacept as either desensitization (n = 32) or maintenance immunosuppression (<jats:italic>n<\/jats:italic> = 20). Among 45 patients who were cytomegalovirus (CMV) donor and\/or recipient seropositive, nine (20%) developed CMV infection. Seven (77%) CMV infections occurred despite valganciclovir prophylaxis and four (44%) were associated with antiviral resistance. Three (6%) LuTRs developed Epstein\u2010Barr virus (EBV) associated post\u2010transplant lymphoproliferative disorder (PTLD). Twenty\u2010five (48%) LuTRs developed 43 bacterial infections and five (10%) developed proven or probable invasive fungal disease. Incidence rates of viral, bacterial, and fungal infections were similar between the desensitization and maintenance groups: incidence rate ratios (95% confidence interval) were 0.70 (0.32\u20131.57), 1.31 (0.70\u20132.46), and 2.82 (0.31\u201325.2), respectively. Infection\/PTLD prompted belatacept discontinuation in eight (15%) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the first year after belatacept initiation, LuTRs commonly developed CMV infections, EBV+ PTLD, and bacterial infections. Multicenter collaborations are needed to better understand infection risks in LuTRs treated with belatacept.\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\/tid14403-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.14403","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T12:10:11Z","timestamp":1730722211000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Epidemiology of Infections in Lung Transplant Recipients Treated With Belatacept"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9424-1870","authenticated-orcid":false,"given":"Madeleine R.","family":"Heldman","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7684-431X","authenticated-orcid":false,"given":"Jennifer L.","family":"Saullo","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon M.","family":"Menachem","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Pulmonary Allergy, and Critical Care Medicine Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6411-198X","authenticated-orcid":false,"given":"Julia A.","family":"Messina","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Arif","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0771-3647","authenticated-orcid":false,"given":"Julie M.","family":"Steinbrink","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4602-1889","authenticated-orcid":false,"given":"Patrick C. K.","family":"Tam","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3187-5905","authenticated-orcid":false,"given":"Manuela","family":"Carugati","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5365-5030","authenticated-orcid":false,"given":"Cameron R.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0914-0291","authenticated-orcid":false,"given":"Arthur W.","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7779-9605","authenticated-orcid":false,"given":"Eileen K.","family":"Maziarz","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra064928"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1189"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14721"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13830"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506027"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2017060679"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16132"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9113479"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16430"},{"key":"e_1_2_9_11_1","unstructured":"Bristol\u2010Meyers Squibb Company.Nulojix (belatacept) package insert. 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