Preemptive use of oral ganciclovir to prevent cytomegalovirus infection in liver transplant patients: A randomized, placebo-controlled trial

  • Carlos V. Paya
  • , Jennie A. Wilson
  • , Mark J. Espy
  • , Irene G. Sia
  • , Michael J. DeBernardi
  • , Thomas F. Smith
  • , Robin Patel
  • , Greg Jenkins
  • , William S. Harmsen
  • , David J. Vanness
  • , Russell H. Wiesner

Research output: Contribution to journalArticlepeer-review

131 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)854-860
Number of pages7
JournalJournal of Infectious Diseases
Volume185
Issue number7
DOIs
StatePublished - Apr 1 2002

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Infectious Diseases

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