Treatment of cytomegalovirus infection after renal transplantation: experience from a single center in China.
Treatment of cytomegalovirus infection after renal transplantation: experience from a single center in China.
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DOI：
10.12659/aot.883859
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发表时间：
2013-03
影响因子：
1.1
通讯作者：
Yang Li;Hang Yan;W. Xue;P. Tian;Xiaoming Ding;Xiao-ming Pan;Xin-shun Feng;H. Xiang;J. Hou;Xiao-hui Tian;Jin Zheng;C. Ding;P. Fan;Hongbao Liu
中科院分区：
文献类型：
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作者：
Yang Li;Hang Yan;W. Xue;P. Tian;Xiaoming Ding;Xiao-ming Pan;Xin-shun Feng;H. Xiang;J. Hou;Xiao-hui Tian;Jin Zheng;C. Ding;P. Fan;Hongbao Liu
我们比较了两种不同治疗CMV感染的有效性和安全性，包括无症状CMV复制和CMV疾病。材料与方法852例肾移植受者，包括无症状CMV复制和CMV病，接受静脉注射无环鸟苷或以静脉注射更昔洛韦为主的综合抗感染治疗。结果更昔洛韦治疗无症状CMV复制（98.96% vs.84.90%）和CMV病（96.29% vs.50.36%）的总有效率均高于对照组（P < 0.05）。更昔洛韦显著缩短了无症状CMV复制（15.0 ± 2.3天vs. 16.0 ± 3.4天）和CMV疾病（19.7 ± 3.1天vs. 21.5 ± 4.0天）的抗病毒治疗时间。更昔洛韦治疗无症状CMV复制（8% vs. 14%）和CMV疾病（11% vs. 22%）的急性移植物排斥反应发生率显著降低。急性排斥反应患者移植肾中检测到CMV-IEA。无环鸟苷组CMV相关急性排斥反应发生率高于更昔洛韦组。除更昔洛韦组贫血、白细胞减少症和贫血发生率较高外，两种药物的安全性相似。结论以静脉注射更昔洛韦为主的综合抗感染方案能有效治疗CMV感染，缩短疗程，减少急性排斥反应。少数不良反应对更昔洛韦使用的影响可以忽略不计。
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.