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Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation
INTRODUCTION: Primary infection or reactivation of Epstein-Barr Virus (EBV) is a significant cause of morbidity and mortality in pediatric kidney transplantation. Valganciclovir (VGC) treatment is recommended for prophylaxis of cytomegalovirus infection, but its role for the prevention of EBV infect...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871758/ https://www.ncbi.nlm.nih.gov/pubmed/36704127 http://dx.doi.org/10.3389/fped.2022.1085101 |
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author | Cheyssac, Elodie Savadogo, Hamidou Lagoutte, Nathan Baudouin, Véronique Charbit, Marina Novo, Robert Sellier-Leclerc, Anne-Laure Fila, Marc Decramer, Stéphane Merieau, Elodie Zaloszyc, Ariane Harambat, Jérôme Roussey, Gwenaelle |
author_facet | Cheyssac, Elodie Savadogo, Hamidou Lagoutte, Nathan Baudouin, Véronique Charbit, Marina Novo, Robert Sellier-Leclerc, Anne-Laure Fila, Marc Decramer, Stéphane Merieau, Elodie Zaloszyc, Ariane Harambat, Jérôme Roussey, Gwenaelle |
author_sort | Cheyssac, Elodie |
collection | PubMed |
description | INTRODUCTION: Primary infection or reactivation of Epstein-Barr Virus (EBV) is a significant cause of morbidity and mortality in pediatric kidney transplantation. Valganciclovir (VGC) treatment is recommended for prophylaxis of cytomegalovirus infection, but its role for the prevention of EBV infection remains controversial. PATIENTS AND METHODS: All pediatric kidney transplant recipients aged <18 years old were considered for inclusion in this retrospective study. EBV negative recipients with an EBV positive donor (a group at risk of primary infection) or EBV positive recipients (a group at risk of reactivation) were included. Severe infection was defined by post-transplant lymphoproliferative disorder (PTLD), symptomatic EBV infection or by asymptomatic EBV infection with a viral load >4.5 log/ml. Outcomes were compared between patients receiving VGC prophylaxis (group P+) and those not receiving VGC prophylaxis (group P−). RESULTS: A total of 79 patients were included, 57 (72%) in the P+ group and 22 (28%) in the P− group; 25 (31%) were at risk of primary infection and 54 (69%) at risk of reactivation. During the first year post-transplant, the occurrence of severe EBV infection was not different between the P+ group (n = 13, 22.8%) and the P− group (n = 5, 22.7%) (p = 0.99). Among patients at risk of primary infection, the rate of severe EBV infection was not different between the two groups (42.1% in P+ vs. 33.3% in P−). A higher frequency of neutropenia was found in the P+ group (66.6%) than in the P− group (33.4%) (p < 0.01). CONCLUSION: Our observational study suggests no effect of VGC for the prevention of EBV infection in pediatric kidney transplant recipients, irrespective of their EBV status. Adverse effects revealed an increased risk of neutropenia. |
format | Online Article Text |
id | pubmed-9871758 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98717582023-01-25 Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation Cheyssac, Elodie Savadogo, Hamidou Lagoutte, Nathan Baudouin, Véronique Charbit, Marina Novo, Robert Sellier-Leclerc, Anne-Laure Fila, Marc Decramer, Stéphane Merieau, Elodie Zaloszyc, Ariane Harambat, Jérôme Roussey, Gwenaelle Front Pediatr Pediatrics INTRODUCTION: Primary infection or reactivation of Epstein-Barr Virus (EBV) is a significant cause of morbidity and mortality in pediatric kidney transplantation. Valganciclovir (VGC) treatment is recommended for prophylaxis of cytomegalovirus infection, but its role for the prevention of EBV infection remains controversial. PATIENTS AND METHODS: All pediatric kidney transplant recipients aged <18 years old were considered for inclusion in this retrospective study. EBV negative recipients with an EBV positive donor (a group at risk of primary infection) or EBV positive recipients (a group at risk of reactivation) were included. Severe infection was defined by post-transplant lymphoproliferative disorder (PTLD), symptomatic EBV infection or by asymptomatic EBV infection with a viral load >4.5 log/ml. Outcomes were compared between patients receiving VGC prophylaxis (group P+) and those not receiving VGC prophylaxis (group P−). RESULTS: A total of 79 patients were included, 57 (72%) in the P+ group and 22 (28%) in the P− group; 25 (31%) were at risk of primary infection and 54 (69%) at risk of reactivation. During the first year post-transplant, the occurrence of severe EBV infection was not different between the P+ group (n = 13, 22.8%) and the P− group (n = 5, 22.7%) (p = 0.99). Among patients at risk of primary infection, the rate of severe EBV infection was not different between the two groups (42.1% in P+ vs. 33.3% in P−). A higher frequency of neutropenia was found in the P+ group (66.6%) than in the P− group (33.4%) (p < 0.01). CONCLUSION: Our observational study suggests no effect of VGC for the prevention of EBV infection in pediatric kidney transplant recipients, irrespective of their EBV status. Adverse effects revealed an increased risk of neutropenia. Frontiers Media S.A. 2023-01-10 /pmc/articles/PMC9871758/ /pubmed/36704127 http://dx.doi.org/10.3389/fped.2022.1085101 Text en © 2023 Cheyssac, Savadogo, Lagoutte, Baudouin, Charbit, Novo, Sellier-Leclerc, Fila, Decramer, Merieau, Zaloszyc, Harambat and Roussey. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Cheyssac, Elodie Savadogo, Hamidou Lagoutte, Nathan Baudouin, Véronique Charbit, Marina Novo, Robert Sellier-Leclerc, Anne-Laure Fila, Marc Decramer, Stéphane Merieau, Elodie Zaloszyc, Ariane Harambat, Jérôme Roussey, Gwenaelle Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation |
title | Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation |
title_full | Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation |
title_fullStr | Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation |
title_full_unstemmed | Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation |
title_short | Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation |
title_sort | valganciclovir is not associated with decreased ebv infection rate in pediatric kidney transplantation |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871758/ https://www.ncbi.nlm.nih.gov/pubmed/36704127 http://dx.doi.org/10.3389/fped.2022.1085101 |
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