Incidence and severity of cytomegalovirus infection in seropositive heart transplant recipients

• Published in: Clinical transplantation 2023-06, Vol.37 (6), p.e14982-e14982
• Main Authors: Gardiner, Bradley J, Bailey, Jessica P, Percival, Mia A, Morgan, Beth A, Warner, Victoria M, Lee, Sue J, Morrissey, C Orla, Kaye, David M, Peleg, Anton Y, Taylor, Andrew J
• Format: Article
• Language: English
• Subjects: Antiviral Agents - therapeutic use; Cytomegalovirus Infections - epidemiology; Cytomegalovirus Infections - etiology; Cytomegalovirus Infections - prevention & control; Ganciclovir - therapeutic use; Heart Transplantation - adverse effects; Humans; Incidence; Original; Retrospective Studies; Transplant Recipients; Valganciclovir - therapeutic use
• ISSN: 0902-0063; 1399-0012
• DOI: 10.1111/ctr.14982

The frequency and significance of cytomegalovirus (CMV) infection in seropositive (R+) heart transplant recipients (HTR) is unclear, with preventative recommendations mostly extrapolated from other groups. We evaluated the incidence and severity of CMV infection in R+ HTR, to identify risk factors and describe outcomes. R+ HTR from 2010 to 2019 were included. Antiviral prophylaxis was not routinely used, with clinically guided monitoring the local standard of care. The primary outcome was CMV infection within one-year post-transplant; secondary outcomes included other herpesvirus infections and mortality. CMV infection occurred in 27/155 (17%) R+ HTR. Patients with CMV had a longer hospitalization (27 vs. 20 days, unadjusted HR 1.02, 95% CI 1.00-1.02, p = .01), higher rate of intensive care readmission (26% vs. 9%, unadjusted HR 3.46, 1.46-8.20, p = .005), and increased mortality (33% vs. 8%, unadjusted HR 10.60, 4.52-24.88, p