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In a post-hoc analysis of the association of CMV DNAemia with long-term mortality in a randomized trial of CMV preemptive therapy vs. antiviral prophylaxis in D+R- liver transplant recipients, post-intervention CMV DNAemia was associated with increased mortality after adjusting for study arm.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10954330 | PMC |
http://dx.doi.org/10.1093/cid/ciad643 | DOI Listing |
Clin Microbiol Infect
August 2025
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Objectives: Epstein-Barr virus (EBV) reactivation following allogeneic hematopoietic cell transplantation (allo-HCT) is associated with increased mortality and possible post-transplant lymphoproliferative disorder (PTLD). With the lack of prophylactic agents, identifying modifiable risk factors to prevent EBV-related mortality is desired. Cytomegalovirus (CMV) DNAemia has been previously associated with EBV DNAemia; the impact of letermovir prophylaxis on this association remains unclear.
View Article and Find Full Text PDFAm J Transplant
August 2025
Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, CA. Electronic address:
Whether ganciclovir-resistant cytomegalovirus (ganR-CMV) can establish latency and reactivate absent any selective drug pressure is unknown and has implications for selecting empiric antiviral therapy in patients with prior ganR-CMV. A CMV-seronegative patient underwent bilateral lung transplant from a CMV-seropositive donor and developed biopsy-confirmed CMV colitis with ganR-CMV (UL97 genotype: M460I, A594E; UL54 genotype: F412L, E756D) four years post-transplant despite prolonged valganciclovir prophylaxis. Foscarnet therapy led to CMV DNAemia clearance and disease resolution.
View Article and Find Full Text PDFHematol Oncol Stem Cell Ther
July 2025
Department of Pediatrics, Section of Infectious Disease, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Background: Human cytomegalovirus (CMV) is a major source of morbidity and mortality in pediatric hematopoietic stem cell transplantation (HSCT). CMV replication is mainly controlled by T-cell-mediated immunity. Despite treatment, CMV reactivation continues to have a significant adverse impact on post-transplant outcomes.
View Article and Find Full Text PDFClin Transplant
August 2025
Infectious and Tropical Diseases Unit, Department of Medicine and Surgery, University of Insubria, ASST Sette Laghi, Varese, Italy.
New options for prevention and therapy of cytomegalovirus (CMV) infection and new tests for antiviral immune reconstitution are leading to increased complexity in the management of CMV after allogeneic hematopoietic stem cell (allo-HSCT) and solid organ transplantation (SOT) recipients. To inform the optimal care of these patients, under the auspices of the Italian GITMO, SITO, SIMIT, and AMCLI transplant, infectious, and clinical microbiology societies, we updated the guidelines published in 2019. New recommendations were produced using a consensus-building methodology after a comprehensive review of articles released from 2019 to 2025 (March).
View Article and Find Full Text PDFAm J Transplant
July 2025
Merck & Co., Inc., Rahway, NJ, USA. Electronic address:
This post-hoc analysis was conducted to understand the impact of kidney function on 200 days of cytomegalovirus (CMV) prophylaxis in CMV donor-positive/recipient-negative (D+R-) kidney transplant recipients (KTRs). Adult CMV D+R- KTRs were randomized (1:1) post-transplant to letermovir 480 mg (with acyclovir and valganciclovir placebo) or valganciclovir 900 mg (with acyclovir and letermovir placebos) daily for 28-weeks (NCT03443869). Valganciclovir and acyclovir doses were modified for kidney function (Cockcroft-Gault creatinine clearance [CrCl]).
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