{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T16:38:45Z","timestamp":1762706325854,"version":"build-2065373602"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"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":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While access and outcomes disparities for African American (AA) kidney transplant recipients are documented, there are limited studies assessing medication access disparities in transplantation. Cytomegalovirus (CMV) causes severe complications for transplant recipients, and we aimed to understand differences in access to CMV prophylaxis valganciclovir and its impact on CMV infection rates in AA transplant recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single\u2010center, retrospective longitudinal cohort study examined high\u2010risk (CMV serostatus D+\/R\u2212) adult kidney transplant recipients between June 1, 2010, and May 31, 202, through EMR abstraction. Standard univariate comparative statistics were employed alongside binary logistic regression for multivariable modeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the 10 year period,\u00a0418 kidney transplant recipients were included, with 179 (42.8%) identified as AA and 239 as non\u2010AA. There were significant differences in mean age (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001) and private versus Medicaid insurance status (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). AAs experienced higher death\u2010censored graft loss rates (10.6% AA vs. 5.0% non\u2010AA,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.031). CMV infection rate, opportunistic infection rate, leukopenia incidence, and death did not differ significantly between AA and non\u2010AA patients. AA patients were 42% less likely to receive valganciclovir out\u2010of\u2010pocket cost assistance compared to non\u2010AA patients (OR 0.58, [0.379\u20130.892],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.013). When incorporating age, Medicaid status, and donor marginality in a multivariable model, the impact of AA race on utilizing assistance programs became statistically non\u2010significant (OR 0.70, [0.448\u20131.094],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.118).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AAs were significantly less likely to leverage assistance programs or utilize personal resources to access valganciclovir. This disparity was partially explained by age, insurance status, and donor type. Despite this, CMV infection rates were similar between AA and non\u2010AA cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.14416","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T09:20:02Z","timestamp":1734513602000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Disparities in Access to Valganciclovir Cytomegalovirus Prophylaxis in High\u2010Risk African American Kidney Transplant Patients"],"prefix":"10.1111","volume":"27","author":[{"given":"Shipra R.","family":"Bethi","sequence":"first","affiliation":[{"name":"College of Medicine Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-4589","authenticated-orcid":false,"given":"David J.","family":"Taber","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika","family":"Andrade","sequence":"additional","affiliation":[{"name":"College of Medicine Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaid M.","family":"Mesmar","sequence":"additional","affiliation":[{"name":"Department of General Surgery Jordan University of Science and Technology  Irbid Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8751-6468","authenticated-orcid":false,"given":"Isabel","family":"Calimlim","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4611-0670","authenticated-orcid":false,"given":"Courtney E.","family":"Harris","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00126334\u2010200501010\u201000017"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.11.031"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc07\u20101341"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.0b013e318203e952"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2020.26.11.1468"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010007\u20100385\u2010z"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2013.1397"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/circoutcomes.116.003166"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0000000000002962"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432\u20102277.2010.01205.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13512"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20103062.2012.00759.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1681\/asn.2008111166"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0b013e3181ff500d"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20103062.2004.00066.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/tp.0b013e318238dab3"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2011.03611.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1145"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0897190014544788"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw668"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2013.01.002"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.23733"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/62.10.1048"},{"issue":"8","key":"e_1_2_10_25_1","first-page":"484","article-title":"Clinical 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