{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T13:54:45Z","timestamp":1736776485940,"version":"3.33.0"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJHP"],"abstract":"<jats:p>Background: Kidney transplantation, while improving outcomes for patients with end-stage renal disease, comes with a risk of potentially life-threatening infections such as infection with cytomegalovirus (CMV), a virus associated with allograft rejection, organ dysfunction, and increased mortality.\u00a0\nObjectives: To characterize whether the choice and dose of immunosuppressant therapy and the duration of antiviral prophylaxis after transplant are associated with the incidence of CMV viremia.\u00a0\nMethods: This study was a retrospective review of all kidney-only transplant recipients at the authors\u2019 centre from 2012 to 2016, with a minimum 1 year of follow-up. Patients with CMV viremia (defined as serum CMV viral load greater than 1000 IU\/mL) were compared with patients who did not have viremia to investigate potential demographic and treatment-related risk factors.\u00a0\nResults: A total of 653 patients were included in the study, of whom 161 (25%) met the criteria for CMV viremia. In univariate analysis, patients with CMV viremia had older age (55 versus 53 years, p = 0.038) and lower mean body weight (75 versus 79 kg, p = 0.015); in addition, the CMV viremia group included larger proportions of patients with Asian descent (40% [64\/161] versus 21% [104\/492]) and donor-positive\/recipient-negative CMV serostatus (29% [47\/161] versus 14% [70\/492]). With respect to immunosuppressant therapy, patients with CMV viremia more frequently received antithymocyte globulin (ATG) induction (50% [80\/161] versus 28% [138\/492], p &lt; 0.001) and received a higher weight-based cumulative ATG dose (mean 4.5 versus 4.1 mg\/kg, p = 0.038). The multivariate analysis retained use of ATG, cumulative dose of ATG, Asian descent, and CMV serostatus as risk factors for CMV viremia. No statistically significant differences were found for the maintenance immunosuppressant dosing or duration of antiviral prophylaxis.\u00a0\nConclusions: Use of ATG for induction and higher weight-based dose of ATG were associated with an increased risk of CMV viremia. In addition, a component of race may also be involved, with patients of Asian descent being at higher risk. No differences were found in the maintenance dose of immunosuppression or the duration of antiviral prophylaxis.\u00a0\n\u00a0R\u00c9SUM\u00c9\u00a0\nContexte : La transplantation r\u00e9nale, bien qu\u2019elle am\u00e9liore les r\u00e9sultats des patients atteints d\u2019insuffisance r\u00e9nale en phase terminale, s\u2019accompagne d\u2019un risque d\u2019infections potentiellement mortelles telles que l\u2019infection par le cytom\u00e9galovirus (CMV) : un virus associ\u00e9 au rejet d\u2019allogreffe, \u00e0 un dysfonctionnement d\u2019organe et \u00e0 une plus grande mortalit\u00e9.\u00a0\nObjectifs : Caract\u00e9riser si le choix et la dose du traitement immunosuppresseur et la dur\u00e9e de la prophylaxie antivirale apr\u00e8s la transplantation sont associ\u00e9s \u00e0 l\u2019incidence de vir\u00e9mie \u00e0 CMV.\u00a0\nM\u00e9thodes : Cette \u00e9tude \u00e9tait un examen r\u00e9trospectif de tous les receveurs d\u2019une transplantation r\u00e9nale uniquement men\u00e9 au centre des auteurs de 2012 \u00e0 2016, avec un suivi d\u2019au moins 1 an. Les patients atteints de vir\u00e9mie \u00e0 CMV (d\u00e9finie comme une charge virale s\u00e9rique CMV sup\u00e9rieure \u00e0 1000 UI\/mL) ont \u00e9t\u00e9 compar\u00e9s \u00e0 des patients sans vir\u00e9mie; cette comparaison avait pour but d\u2019\u00e9tudier les facteurs de risque d\u00e9mographiques ou li\u00e9s aux traitements.\u00a0\nR\u00e9sultats : L\u2019\u00e9tude comprenait 653 patients, dont 161 (25 %) r\u00e9pondaient aux crit\u00e8res de vir\u00e9mie \u00e0 CMV. En analyse univari\u00e9e, l\u2019\u00e2ge des patients atteints de vir\u00e9mie \u00e0 CMV \u00e9tait plus \u00e9lev\u00e9 (55 contre 53 ans, p = 0,038) et leur poids corporel moyen \u00e9tait moins \u00e9lev\u00e9 (75 contre 79 kg, p = 0,015); en outre, le groupe des patients atteints de vir\u00e9mie \u00e0 CMV comprenait une plus grande proportion de patients d\u2019origine asiatique (40 % [64\/161] contre 21 % [104\/492]) et de statut s\u00e9rologique CMV donneur positif\/receveur n\u00e9gatif (29 % [47\/161] contre 14 % [70\/492]). En ce qui concerne le traitement immunosuppresseur, les patients atteints de vir\u00e9mie \u00e0 CMV ont re\u00e7u plus fr\u00e9quemment une induction de s\u00e9rum anti-lymphocytaire (SAL) (50 % [80\/161] contre 28 % [138\/492], p &lt; 0,001) ainsi qu\u2019une dose cumulative de SAL plus \u00e9lev\u00e9e en fonction du poids (moyenne de 4,5 contre 4,1 mg\/kg, p = 0,038). L\u2019analyse multivari\u00e9e a retenu l\u2019utilisation du SAL, la dose cumulative de SAL, l\u2019origine asiatique et le statut s\u00e9rologique du CMV comme facteurs de risque de vir\u00e9mie \u00e0 CMV. Aucune diff\u00e9rence statistiquement significative n\u2019a \u00e9t\u00e9 trouv\u00e9e pour la posologie d\u2019entretien des immunosuppresseurs ou la dur\u00e9e de la prophylaxie antivirale.\u00a0\nConclusions : L\u2019utilisation du SAL pour l\u2019induction et une dose plus \u00e9lev\u00e9e de SAL en fonction du poids \u00e9taient associ\u00e9es \u00e0 un risque accru de vir\u00e9mie \u00e0 CMV. De plus, une composante raciale pourrait \u00e9galement \u00eatre impliqu\u00e9e \u2013 les patients d\u2019origine asiatique \u00e9tant plus \u00e0 risque. Aucune diff\u00e9rence n\u2019a \u00e9t\u00e9 trouv\u00e9e dans la posologie d\u2019entretien des immunosuppresseurs ou la dur\u00e9e de la prophylaxie antivirale.\u00a0<\/jats:p>","DOI":"10.4212\/cjhp.v75i1.3249","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T21:46:09Z","timestamp":1648071969000},"source":"Crossref","is-referenced-by-count":2,"title":["Characterization of Cytomegalovirus Viremia in Renal Transplant Recipients"],"prefix":"10.4212","volume":"75","author":[{"given":"Ishan","family":"Chaudhari","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Leung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bita","family":"Bateni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2732","published-online":{"date-parts":[[2022,1,8]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3249\/4559","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3249\/4560","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3249\/4559","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T21:46:10Z","timestamp":1648071970000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3249"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,8]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,8]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.v75i1.3249","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"type":"electronic","value":"1920-2903"},{"type":"print","value":"0008-4123"}],"subject":[],"published":{"date-parts":[[2022,1,8]]}}}