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https://www.readbyqxmd.com/read/29668137/costo-efectividad-de-dos-esquemas-de-prevenci%C3%A3-n-de-la-infecci%C3%A3-n-por-citomegalovirus-en-pacientes-con-trasplante-renal-y-riesgo-intermedio-en-colombia
#1
Kateir Contreras, María José Vargas, Paola García, Camilo A González, Patricia Rodríguez, Camilo Castañeda-Cardona, Margarita Otálora-Esteban, Diego Rosselli
Introducción. El citomegalovirus es la causa más frecuente de infección en pacientes con trasplante renal. Existen dos estrategias de similar efectividad para prevenirlo: la profilaxis universal con valganciclovir durante 90 días o el tratamiento anticipado verificando la carga viral semanal y aplicándolo solo si esta es positiva.Objetivo. Determinar cuál de estas dos estrategias sería más costo-efectiva en pacientes de riesgo intermedio en Colombia.Materiales y métodos. Se diseñó un árbol de decisiones bajo la perspectiva del tercer pagador considerando únicamente los costos médicos directos en pesos colombianos (COP) del 2014 durante un periodo de un año en una población de pacientes con riesgo intermedio para citomegalovirus (donante positivo y receptor positivo, o donante negativo y receptor positivo)...
March 15, 2018: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/29661141/diagnostic-utility-of-monitoring-cytomegalovirus-specific-immunity-by-quantiferon-cytomegalovirus-assay-in-kidney-transplant-recipients
#2
Dominika Deborska-Materkowska, Agnieszka Perkowska-Ptasinska, Anna Sadowska, Jolanta Gozdowska, Michał Ciszek, Marta Serwanska-Swietek, Piotr Domagala, Dorota Miszewska-Szyszkowska, Elzbieta Sitarek, Agnieszka Jozwik, Artur Kwiatkowski, Magdalena Durlik
BACKGROUND: Despite universal prophylaxis, late cytomegalovirus (CMV) infection occurs in a high proportion of kidney transplant recipients. We evaluated whether a specific viral T-cell response allows for the better identification of recipients who are at high risk of CMV infection after prophylaxis withdrawal. METHODS: We conducted a prospective study in 19 pretransplant anti-CMV seronegative kidney graft recipients R- (18 from seropositive donors [D+] and one from a seronegative donor [D-]) and 67 seropositive recipients R(+) (59 from seropositive donors and eight from seronegative donors) who received antiviral prophylaxis with valganciclovir...
April 16, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29605391/valganciclovir-is-beneficial-in-children-with-congenital-cytomegalovirus-and-isolated-hearing-loss
#3
Yehonatan Pasternak, Liron Ziv, Joseph Attias, Jacob Amir, Efraim Bilavsky
OBJECTIVE: To evaluate the efficacy of antiviral treatment for infants with congenital cytomegalovirus (cCMV) with isolated sensorineural hearing loss (SNHL). STUDY DESIGN: Data were reviewed retrospectively for infants with isolated SNHL who received prolonged antiviral treatment between 2005 and 2017. Hearing status was evaluated for infants who had been followed for >1 year. RESULTS: Among 329 infants treated for cCMV, 59 (18%) were born with isolated SNHL...
March 28, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29602266/cmv-infection-in-heart-transplantation-a-single-center-experience
#4
Ignacio A Echenique, Michael P Angarone, Jonathan Rich, Allen S Anderson, Valentina Stosor
BACKGROUND: CMV infection remains a major complication after heart transplantation with varying prophylaxis strategies employed. We sought to determine the impact of valganciclovir (VGC) duration on the epidemiology of CMV infections after heart transplantation. METHODS: We performed a prospective cohort study of CMV donor (D) or recipient (R) seropositive heart transplant recipients from 2005-2012 who completed VGC prophylaxis, ranging from 3-12 months according to serostatus and induction immunosuppression...
March 30, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29579856/resistant-cytomegalovirus-infection-after-renal-transplantation-literature-review
#5
M Cintra-Cabrera, A Suárez-Benjumea, G Bernal-Blanco, F M González-Roncero, N G Toapanta-Gaibor, M Súñer-Poblet, M Á Pérez-Valdivia, F Fernández-Cuenca, M Á Gentil-Govantes, J L Rocha-Castilla
BACKGROUND: Resistant cytomegalovirus (R-CMV) is an emerging problem in the renal transplantation population. The most frequent CMVs are high-resistance mutations (UL97 gene). METHODS: We describe our experience in management of R-CMV after renal transplant at our center (2012-2016). RESULTS: We encountered 3 cases of R-CMV infection after renal transplant (all primary infections). All 3 patients received induction therapy with corticosteroids, tacrolimus, and mycophenolate mofetil...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29565326/curcuminoids-as-ebv-lytic-activators-for-adjuvant-treatment-in-ebv-positive-carcinomas
#6
Octavia Ramayanti, Mitch Brinkkemper, Sandra A W M Verkuijlen, Leni Ritmaleni, Mei Lin Go, Jaap M Middeldorp
Epstein-Barr virus (EBV) persists in nasopharyngeal (NPC) and gastric carcinomas (EBVaGC) in a tightly latent form. Cytolytic virus activation (CLVA) therapy employs gemcitabine and valproic acid (GCb+VPA) to reactivate latent EBV into the lytic phase and antiviral valganciclovir to enhance cell death and prevent virus production. CLVA treatment has proven safe in phase-I/II trials with promising clinical responses in patients with recurrent NPC. However, a major challenge is to maximize EBV lytic reactivation by CLVA...
March 22, 2018: Cancers
https://www.readbyqxmd.com/read/29558877/incidence-and-risk-factors-for-leukopenia-in-kidney-transplant-recipients-receiving-valganciclovir-for-cytomegalovirus-prophylaxis
#7
Xinyun Liang, Olusegun Famure, Yanhong Li, S Joseph Kim
CONTEXT: Valganciclovir is used not only for cytomegalovirus prophylaxis after kidney transplantation but can also induce leukopenia, thereby making patients more susceptible to other infections. The epidemiology of leukopenia in patients on valganciclovir remains poorly understood. OBJECTIVE: To determine the incidence and risk factors for leukopenia in patients receiving valganciclovir for cytomegalovirus prophylaxis after kidney transplantation. METHODS: In this single-center, retrospective, cohort study, we included kidney recipients transplanted from January 1, 2003, to December 31, 2010, to determine the incidence and risk factors for leukopenia in patients who received valganciclovir for cytomegalovirus prophylaxis...
January 1, 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29546589/valganciclovir-pharmacokinetics-in-patients-receiving-oral-prophylaxis-following-kidney-transplantation-and-model-based-predictions-of-optimal-dosing-regimens
#8
Thomas Tängdén, Pier Giorgio Cojutti, Jason A Roberts, Federico Pea
BACKGROUND AND OBJECTIVES: Valganciclovir is used as oral prophylaxis for cytomegalovirus (CMV) infection in kidney transplant recipients. However, limited pharmacokinetic data exist to guide dosing in this patient group. This study aimed to describe the population pharmacokinetics of valganciclovir in a large sample of kidney transplant recipients and predict optimal dosing based on Monte Carlo simulations. METHODS: Therapeutic drug monitoring (TDM) data from adult kidney transplant recipients who received valganciclovir prophylaxis during a 10-year study period were collected retrospectively...
March 15, 2018: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/29512249/low-dose-valganciclovir-prohylaxis-is-efficacious-and-safe-in-cytomegalovirus-seropositive-heart-transplant-recipients-with-anti-thymocyteglobulin
#9
Mari Eriksson, Janne J Jokinen, Sanni Söderlund, Pekka Hämmainen, Jyri Lommi, Karl B Lemström
BACKGROUND: Cytomegalovirus (CMV) remains an important pathogen in solid organ transplant patients. OBJECTIVE: We executed a hybrid prophylactic and pre-emptive valganciclovir (VGCV) prophylaxis to prevent CMV infection in heart transplant patients with antithymocyteglobulin (ATG) induction and retrospectively evaluated the efficacy and safety of this regimen. METHODS: 100 adult heart transplant patients between 2004 and 2010 were included...
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29500912/low-dose-valganciclovir-for-cytomegalovirus-prophylaxis-in-intermediate-risk-liver-transplant-recipients
#10
Salman Khan, Timothy Sullivan, Mohsin Ali, Dallas Dunn, Gopi Patel, Shirish Huprikar
BACKGROUND: Liver transplant recipients (LTR) who are seropositive for cytomegalovirus (CMV) (R+) are at intermediate-risk for CMV disease. A preventive strategy following transplant is considered standard of care. Current guidelines recommend high-dose valganciclovir (VGCV) (900 mg/day adjusted for renal function) for prophylaxis given limited data on the efficacy and safety of low-dose VGCV (450 mg/day adjusted for renal function). We describe our experience using low-dose VGCV prophylaxis for R+ LTR at our institution...
March 3, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29407298/high-dose-valganciclovir-treatment-for-resistant-cytomegalovirus-colitis-due-to-ul97-and-ul54-mutations
#11
K M Baradhi, R L Aure, J-M El-Amm
We report the first case of a ganciclovir-resistant cytomegalovirus (CMV) involving the gastrointestinal tract that was successfully treated with high-dose valganciclovir. A kidney transplant recipient developed drug-resistant CMV colitis which was initially treated with valganciclovir, but his CMV was found to have major resistance to ganciclovir and cidofovir due to UL97 and UL54 mutations. The patient was switched to intravenous foscarnet 40 mg/kg given every twelve hours. However, foscarnet had to be discontinued after 4 days of treatment due to acute kidney injury...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29407294/prevention-of-late-onset-cytomegalovirus-infection-and-disease-in-donor-positive-recipient-negative-kidney-transplant-recipients-using-low-dose-valganciclovir
#12
K Nanmoku, T Shinzato, T Kubo, T Shimizu, T Kimura, T Yagisawa
BACKGROUND: The main challenge with cytomegalovirus (CMV) prophylaxis in IgG donor-positive/recipient-negative (D+/R-) kidney transplant recipients is late-onset CMV disease. We evaluated a novel protocol for the prevention of late-onset CMV infection and disease in D+/R- organ recipients. METHODS: Our prospective, observational, cohort study included 100 adult kidney transplant recipients. Prophylaxis with low-dose valganciclovir (450 mg/d, 3 times a week for 6 months) was administered to D+/R- recipients...
January 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29397198/valganciclovir-use-among-commercially-and-medicaid-insured-infants-with-congenital-cmv-infection-in-the-united-states-2009-2015
#13
Jessica Leung, Sheila C Dollard, Scott D Grosse, Winnie Chung, ThuyQuynh Do, Manisha Patel, Tatiana M Lanzieri
PURPOSE: The aim of this study was to assess the clinical characteristics and trends in valganciclovir use among infants diagnosed with congenital cytomegalovirus (CMV) disease in the United States. METHODS: We analyzed data from medical claims dated 2009-2015 from the Truven Health MarketScan® Commercial Claims and Encounters and Medicaid databases. We identified infants with a live birth code in the first claim who were continuously enrolled for at least 45 days...
January 31, 2018: Clinical Therapeutics
https://www.readbyqxmd.com/read/29363584/neurogenesis-during-abstinence-is-necessary-for-context-driven-methamphetamine-related-memory
#14
Melissa H Galinato, Yoshio Takashima, McKenzie J Fannon, Leon W Quach, Roberto J Morales Silva, Karthik K Mysore, Michael J Terranova, Rahul R Dutta, Ryan W Ostrom, Sucharita S Somkuwar, Chitra D Mandyam
Abstinence from methamphetamine addiction enhances proliferation and differentiation of neural progenitors and increases adult neurogenesis in the dentate gyrus (DG). We hypothesized that neurogenesis during abstinence contributes to context-driven drug-seeking behaviors. To test this hypothesis, the pharmacogenetic rat model (GFAP-TK rats) was used to conditionally and specifically ablate neurogenesis in the DG. Male GFAP-TK rats were trained to self-administer methamphetamine or sucrose and were administered the antiviral drug valganciclovir (Valcyte) to produce apoptosis of actively dividing GFAP type 1 stem-like cells to inhibit neurogenesis during abstinence...
February 21, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29360250/impact-of-electronic-health-record-based-pharmacist-driven-valganciclovir-dose-optimization-in-solid-organ-transplant-recipients
#15
David Hensler, Chad L Richardson, Joslyn Brown, Christine Tseng, Phyllis J DeCamp, Amy Yang, Anna Pawlowski, Bing Ho, Michael G Ison
BACKGROUND: Prophylaxis with valganciclovir reduces the incidence of cytomegalovirus (CMV) infection following solid organ transplant (SOT). Under-dosing of valganciclovir is associated with an increased risk of CMV infection and development of ganciclovir-resistant CMV. METHODS: An automated electronic health record (EHR)-based, pharmacist-driven program was developed to optimize dosing of valganciclovir in solid organ transplant recipients at a large transplant center...
April 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29306112/predictive-factors-of-spontaneous-cmv-dnaemia-clearance-in-kidney-transplantation
#16
Johan Noble, Philippe Gatault, Bénédicte Sautenet, Catherine Gaudy-Graffin, Agnes Beby-Defaux, Antoine Thierry, Marie Essig, Jean-Michel Halimi, Eliza Munteanu, Sophie Alain, Matthias Buchler
Cytomegalovirus (CMV) infection occurs frequently after solid organ transplantation. Therapeutic strategies, in particular when to start a curative treatment, has not yet been defined. The purpose of this study was to assess predictive factors associated with spontaneous clearance of CMV DNAemia in kidney transplant recipients. METHODS: All kidney recipients of a single center were recruited. Patients with at least one positive CMV DNAemia during the first year post transplantation were included in our analysis...
February 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29222255/non-chemotherapy-drug-induced-neutropenia-key-points-to-manage-the-challenges
#17
REVIEW
Brian R Curtis
Non-chemotherapy idiosyncratic drug-induced neutropenia (IDIN) is a relatively rare but potentially fatal disorder that occurs in susceptible individuals, with an incidence of 2.4 to 15.4 cases per million population. Affected patients typically experience severe neutropenia within several weeks to several months after first exposure to a drug, and mortality is ∼5%. The drugs most frequently associated with IDIN include metamizole, clozapine, sulfasalazine, thiamazole, carbimazole, amoxicillin, cotrimoxazole, ticlopidine, and valganciclovir...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29215460/comparison-of-preemptive-therapy-and-antiviral-prophylaxis-for-prevention-of-cytomegalovirus-in-seropositive-liver-transplant-recipients
#18
Amy W Liu, Kamonwan Jutivorakool, Cynthia E Fisher, Robert M Rakita, Jorge D Reyes, Renuka B Bhattacharya, Keith R Jerome, Ajit P Limaye
BACKGROUND: Few studies have directly compared preemptive therapy (PET) and antiviral prophylaxis (AP) for prevention of cytomegalovirus disease in CMV seropositive (R+) orthotopic liver transplant (OLT) recipients. METHODS: We prospectively assessed CMV disease and clinical outcomes among 160 consecutive R+ OLT recipients who received PET (weekly plasma CMV PCR for 3 months, oral valganciclovir 900 mg twice daily for CMV viremia >250 IU/mL, until 2 consecutive negative weekly PCR results) and compared them to a historical cohort of 156 R+ recipients who received AP (valganciclovir 900 mg daily for 3 months)...
December 5, 2017: Transplantation
https://www.readbyqxmd.com/read/29201472/severe-cytomegalovirus-reactivation-in-patient-with-low-grade-non-hodgkin-s-lymphoma-after-standard-chemotherapy
#19
Lena Modvig, Ciaran Boyle, Katie Randall, Anton Borg
Clinically significant cytomegalovirus (CMV) reactivation is not uncommon in patients with severe immunodeficiency secondary to underlying medical disorders or following aggressive immunosuppressive therapy. However, it is less frequently found in patients with low-grade haematological malignancies after nonintensive chemotherapy. We treated a patient at our centre for stage IVB follicular lymphoma with standard chemotherapy who successively developed CMV colitis associated with a CMV viral load of >3 million copies/ml...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/29198661/prolonged-low-dose-prophylaxis-with-valganciclovir-in-cytomegalovirus-negative-recipients-of-kidney-transplants-from-cytomegalovirus-positive-donors-allows-seroconversion-and-prevents-cytomegalovirus-disease
#20
F Halleck, D Khadzhynov, E Schrezenmeier, L Lehner, K Budde, O Staeck
BACKGROUND: Cytomegalovirus-negative recipients of kidneys from cytomegalovirus (CMV)-positive donors (D+/R-) are at high risk to develop severe clinical manifestations of CMV disease. Long-term data about incidence and timing of CMV seroconversion, CMV disease, and the influence of prolonged valganciclovir prophylaxis on the clinical course of CMV infection are missing. METHODS: We conducted a retrospective long-term study of 89 consecutive CMV D+/R- kidney transplant recipients transplanted between 2003 and 2012...
December 2017: Transplantation Proceedings
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