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Herpes zoster in kidney transplant recipients: protective effect of anti-cytomegalovirus prophylaxis and natural killer cell count. A single-center cohort study
- Source :
- Transplant international : official journal of the European Society for Organ Transplantation. 31(2)
- Publication Year :
- 2017
-
Abstract
- Despite its impact on quality of life and potential for complications, specific risk and protective factors for herpes zoster (HZ) after kidney transplantation (KT) remain to be clarified. We included 444 patients undergoing KT between November 2008 and March 2013. Peripheral blood lymphocyte subpopulations were measured at baseline and months 1 and 6. The risk factors for early (first post-transplant year) and late HZ (years 1-5) were separately assessed. We observed 35 episodes of post-transplant HZ after a median follow-up of 48.3 months (incidence rate: 0.057 per 1000 transplant-days). Median interval from transplantation was 18.3 months. Six patients (17.1%) developed disseminated infection. Postherpetic neuralgia occurred in 10 cases (28.6%). The receipt of anti-cytomegalovirus (CMV) prophylaxis with (val)ganciclovir decreased the risk of early HZ [adjusted hazard ratio (aHR): 0.08; 95% CI: 0.01-1.13; P-value = 0.062], whereas the natural killer (NK) cell at month 6 was protective for the occurrence of late HZ [aHR (per 10-cells/μl increase): 0.94; 95% CI: 0.88-1.00; P-value = 0.054]. In conclusion, two easily ascertainable factors (whether the patient is receiving anti-CMV prophylaxis and the NK cell count at month 6) might be potentially useful to tailor preventive strategies according to individual susceptibility to post-transplant HZ.
- Subjects :
- Ganciclovir
Adult
Graft Rejection
Male
medicine.medical_specialty
Cytomegalovirus
030230 surgery
Single Center
Gastroenterology
Antiviral Agents
Chemoprevention
Herpes Zoster
Risk Assessment
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
030212 general & internal medicine
Kidney transplantation
Aged
Retrospective Studies
Transplantation
Postherpetic neuralgia
business.industry
Incidence (epidemiology)
Hazard ratio
Graft Survival
Middle Aged
medicine.disease
Prognosis
Kidney Transplantation
Transplant Recipients
Killer Cells, Natural
ROC Curve
Peripheral blood lymphocyte
Immunology
Cytomegalovirus Infections
Multivariate Analysis
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 14322277
- Volume :
- 31
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Transplant international : official journal of the European Society for Organ Transplantation
- Accession number :
- edsair.doi.dedup.....d29bc57d2eead6af609c09bd72c69e5a