{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T03:56:07Z","timestamp":1790826967934,"version":"4.1.0"},"reference-count":32,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T00:00:00Z","timestamp":1603843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Conversion from calcineurin-inhibitors (CNIs) to belatacept can help kidney-transplant (KT) recipients avoid CNI-related nephrotoxicity. The risk of associated opportunistic infections (OPIs) is ill-defined. We conducted a multicentric cohort study across 15 French KT-centers in a real-life setting. Between 07-2010 and 07-2019, 453 KT recipients were converted from CNI- to belatacept-based therapy at 19 [0.13\u2013431] months post-transplantation. Most patients, i.e., 332 (79.3%), were converted after 6-months post-transplantation. Follow-up time after conversion was 20.1 +\/\u2212 13 months. OPIs developed in 42(9.3%) patients after 14 +\/\u2212 12 months post-conversion. Eight patients (19%) had two OPI episodes during follow-up. Incidences of CMV DNAemia and CMV disease were significantly higher in patients converted before 6-months post-KT compared to those converted later (i.e., 31.6% vs. 11.5%; p &lt; 0.001; and 11.6% vs. 2.4%, p &lt; 0.001, respectively). Cumulative incidence of OPIs was 6.5 OPIs\/100 person\u2013years. Incidence of CMV disease was 2.8\/100 person\u2013years, of pneumocystis pneumonia 1.6\/100 person\u2013years, and of aspergillosis 0.2\/100 person\u2013years. Multivariate analyses showed that estimated glomerular filtration (eGFR) &lt; 25 mL\/min\/1.73 m2 at conversion was independently associated with OPIs (HR = 4.7 (2.2 \u2212 10.3), p &lt; 0.001). The incidence of EBV DNAemia was 17.3 events \/100 person\u2013years. At 1-year post-conversion, mean eGFR had significantly increased from 32.0 +\/\u2212 18 mL\/min\/1.73 m2 to 42.2 +\/\u2212 18 mL\/min\/1.73 m2 (p &lt; 0.0001). Conversion to belatacept is an effective strategy with a low infectious risk.<\/jats:p>","DOI":"10.3390\/jcm9113479","type":"journal-article","created":{"date-parts":[[2020,10,29]],"date-time":"2020-10-29T23:06:12Z","timestamp":1604012772000},"page":"3479","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Opportunistic Infections and Efficacy Following Conversion to Belatacept-Based Therapy after Kidney Transplantation: A French Multicenter Cohort"],"prefix":"10.3390","volume":"9","author":[{"given":"Dominique","family":"Bertrand","sequence":"first","affiliation":[{"name":"Department of Nephrology and Transplantation, Rouen University Hospital, 76000 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Terrec","sequence":"additional","affiliation":[{"name":"Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, University Hospital Grenoble, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Etienne","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, Rouen University Hospital, 76000 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Chavarot","sequence":"additional","affiliation":[{"name":"Department of Adult Kidney Transplantation, Necker-Enfants Malades University Hospital, 75000 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Sberro","sequence":"additional","affiliation":[{"name":"Department of Adult Kidney Transplantation, Necker-Enfants Malades University Hospital, 75000 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1664-2879","authenticated-orcid":false,"given":"Philippe","family":"Gatault","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Tours University Hospital, 37000 Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyril","family":"Garrouste","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Clermont Ferrand University Hospital, 63000 Clermont Ferrand, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Bouvier","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Caen University Hospital, 14000 Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Grall-Jezequel","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Brest University Hospital, 28200 Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00eft\u00e9","family":"Jaureguy","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Amiens University Hospital, 80000 Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Caillard","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Strasbourg University Hospital, 67000 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Thervet","sequence":"additional","affiliation":[{"name":"Department of Nephrology, European Georges Pompidou University Hospital, 75000 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Colosio","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Reims University Hospital, 51100 Reims, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Golbin","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Rennes University Hospital, 35000 Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Rerolle","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Limoges University Hospital, 87000 Limoges, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Thierry","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Poitiers University Hospital, 86000 Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny","family":"Sayegh","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Angers University Hospital, 49000 Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9n\u00e9dicte","family":"Janbon","sequence":"additional","affiliation":[{"name":"Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, University Hospital Grenoble, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Malvezzi","sequence":"additional","affiliation":[{"name":"Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, University Hospital Grenoble, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9016-7506","authenticated-orcid":false,"given":"Thomas","family":"Jouve","sequence":"additional","affiliation":[{"name":"Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, University Hospital Grenoble, 38000 Grenoble, France"},{"name":"Department of Adult Kidney Transplantation, Necker-Enfants Malades University Hospital, 75000 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5130-7286","authenticated-orcid":false,"given":"Lionel","family":"Rostaing","sequence":"additional","affiliation":[{"name":"Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, University Hospital Grenoble, 38000 Grenoble, France"},{"name":"Department of Adult Kidney Transplantation, Necker-Enfants Malades University Hospital, 75000 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2329-0392","authenticated-orcid":false,"given":"Johan","family":"Noble","sequence":"additional","affiliation":[{"name":"Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, University Hospital Grenoble, 38000 Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2562","DOI":"10.1056\/NEJMoa067411","article-title":"Reduced exposure to calcineurin inhibitors in renal transplantation","volume":"357","author":"Ekberg","year":"2007","journal-title":"N. 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