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Medical Science Monitor Basic Research


eISSN: 2329-0358

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Treatment of Cytomegalovirus infection after renal transplantation: Experience from a Single Center in China

Yang Li, Hang Yan, Wu-Jun Xue, Pu-Xun Tian, Xiao-Ming Ding, Xiao-Ming Pan, Xin-Shun Feng, He-Li Xiang, Jun Hou, Xiao-Hui Tian, Jin Zheng, Chen-Guang Ding, Ping Fan, Hong-Bao Liu

Ann Transplant 2013; 18:124-134

DOI: 10.12659/AOT.883859

Background: We compared the efficacy and safety of 2 different treatments of CMV infection, including asymptomatic CMV replication and CMV disease.
Material and Methods: 852 renal transplantation recipients, including asymptomatic CMV replication and CMV disease, received antiviral therapies of intravenous acyclovir or comprehensive anti-infection solution, mainly with intravenous ganciclovir. Effect, time, acute allograft rejection, and safety were analyzed during the antiviral therapy
Results: The total effective rates were higher with ganciclovir in both asymptomatic CMV replication (98.96% vs. 84.90%) and CMV disease (96.29% vs. 50.36%). Ganciclovir significantly shortened antiviral therapy duration in both asymptomatic CMV replication (15.0±2.3 days vs. 16.0±3.4 days) and CMV disease (19.7±3.1 days vs. 21.5±4.0 days). The acute allograft rejection incidences were significantly lower with ganciclovir in both asymptomatic CMV replication (8% vs. 14%) and CMV disease (11% vs. 22%). CMV-IEA was detected in renal grafts of patients with acute rejection. There was more CMV-associated acute rejection using acyclovir than using ganciclovir. Except for the higher incidence of anemia leucopenia and anemia with ganciclovir, the safety profiles of both drugs were similar.
Conclusions: Comprehensive anti-infection solution, mainly with intravenous ganciclovir, can effectively treat CMV infection, shorten duration of therapy, and decrease acute rejection. The few adverse effects had negligible effects on use of ganciclovir.

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