Publisher： John Wiley & Sons Inc
E-ISSN： 1399-3062|17|4|497-509
ISSN： 1398-2273
Source： TRANSPLANT INFECTIOUS DISEASE (ELECTRONIC), Vol.17, Iss.4, 2015-08, pp. : 497-509
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Abstract
AbstractBackgroundThe incidence and the impact of asymptomatic cytomegalovirus (CMV) DNAemia occurring after the first year post transplantation is unknown.MethodsIn this retrospective cross‐sectional study, we analyzed the incidence, risk factors, and impact of 2‐year post‐transplantation asymptomatic CMV DNAemia (2YCD) on graft function. We included 892 consecutive asymptomatic kidney transplant recipients transplanted for at least 2 years and all were monitored using whole blood CMV quantitative nucleic acid amplification testing (CMV‐QNAT).ResultsTwenty‐eight patients displayed 2YCD (3.1%). Using multivariate analysis in 578 patients, we found that female gender (odds ratio [OR] = 2.57, P = 0.02), a past history of CMV drug‐resistance mutation (OR = 8.73, P = 0.005), and corticosteroid use (OR = 2.37, P = 0.03) were independently associated with an increased risk of 2YCD. 2YCD was associated with an increased incidence of subsequent CMV disease over the year following its diagnosis (7% vs. 0.6%, P = 0.02). Patients with 2YCD also exhibited a declining estimated glomerular filtration rate more frequently (77%) than patients with a negative CMV‐QNAT (56%, P = 0.02).Conclusion2YCD appears to be a rare entity, which appears to be associated with chronic graft dysfunction.
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