Preemptive use of oral ganciclovir to prevent cytomegalovirus infection in liver transplant patients: a randomized, placebo-controlled trial.
Preemptive use of oral ganciclovir to prevent cytomegalovirus infection in liver transplant patients: a randomized, placebo-controlled trial.
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DOI：
10.1086/339449
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发表时间：
2002-04
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影响因子：
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通讯作者：
C. Payá;Jennie A. Wilson;M. Espy;I. Sia;Michael J. DeBernardi;T. F. Smith;Robin Patel;G. Jenkins-G.-Je
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文献类型：
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作者：
C. Payá;Jennie A. Wilson;M. Espy;I. Sia;Michael J. DeBernardi;T. F. Smith;Robin Patel;G. Jenkins-G.-Je
使用检测后巨细胞病毒（CMV）抗病毒治疗作为预防实体器官移植患者感染和疾病的策略尚未通过安慰剂对照试验进行评估。我们在69例接受肝移植的患者中进行了这样的研究，这些患者在移植后8周内CMV聚合酶链反应结果呈阳性，但没有伴随CMV感染或疾病。这些患者被随机分配接受安慰剂或口服更昔洛韦8周。安慰剂组中CMV感染发生率为21%，疾病发生率为12%（P = 0.022），而更昔洛韦组分别为3%和0%（P = 0.003）。同样，在安慰剂组中，接受CMV阳性供体器官的CMV阴性患者中分别有55%和36%发生CMV感染或疾病（P = 0.02），而更昔洛韦组中这类患者的发生率分别为11%和0%（P <0.01）。口服更昔洛韦对PCR检测CMV预防肝移植后CMV感染或疾病。
The use of postdetection antiviral treatment of cytomegalovirus (CMV) as a strategy to prevent infection and disease in solid-organ transplant patients has not been evaluated by placebo-controlled trials. We carried out such a study in 69 patients who had received liver transplants and had positive results of CMV polymerase chain reaction within 8 weeks after transplantation but did not have concomitant CMV infection or disease. These patients were randomly assigned to receive placebo or oral ganciclovir for 8 weeks. CMV infection developed in 21% and disease developed in 12% of placebo recipients (P =.022), compared with 3% and 0%, respectively, among ganciclovir recipients (P =.003). Similarly, in the placebo arm, 55% and 36% of CMV-negative patients who received organs from CMV-positive donors developed CMV infection or disease, respectively (P =.02), compared with 11% and 0% of such patients in the ganciclovir arm (P <.01). Oral ganciclovir administered on CMV detection by PCR prevents CMV infection or disease after liver transplantation.