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Prophylaxis followed by preemptive therapy versus preemptive therapy for prevention of human cytomegalovirus disease in pediatric patients undergoing liver transplantation.
- Source :
-
Transplantation [Transplantation] 2008 Jul 15; Vol. 86 (1), pp. 163-6. - Publication Year :
- 2008
-
Abstract
- Twenty-one pediatric liver transplant recipients were enrolled in a study comparing prophylaxis followed by preemptive therapy (10 patients) versus preemptive therapy alone (11 patients) for prevention of human cytomegalovirus (HCMV) disease. In the prophylaxis arm, patients were treated with ganciclovir for 30 days, then preemptive therapy was initiated with virologic monitoring for pp65 antigenemia. In the preemptive therapy arm, patients were treated on reaching 100,000 DNA copies/mL whole blood. An interim analysis showed that, although numbers of both infected and treated patients were comparable in the two arms, the median number of total days of antiviral therapy per patient (30 vs. 18, P<0.01) was significantly higher in the prophylaxis arm. No case of HCMV disease occurred in either arm. Therefore, the trial was interrupted and prophylaxis replaced with preemptive therapy alone. In parallel, the development of T-cell-mediated immune response was found to be comparable in both arms.
- Subjects :
- Antigens, Viral blood
Child
Child, Preschool
Cytomegalovirus genetics
Cytomegalovirus immunology
Cytomegalovirus Infections etiology
Cytomegalovirus Infections immunology
DNA, Viral blood
Drug Administration Schedule
Humans
Immunity, Cellular drug effects
Infant
Phosphoproteins blood
T-Lymphocytes drug effects
T-Lymphocytes immunology
Treatment Outcome
Viral Matrix Proteins blood
Antiviral Agents administration & dosage
Cytomegalovirus Infections prevention & control
Ganciclovir administration & dosage
Liver Transplantation adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 0041-1337
- Volume :
- 86
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 18622294
- Full Text :
- https://doi.org/10.1097/TP.0b013e31817889e4