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Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
Published on: May 27, 2011
Prevention of cytomegalovirus infection after solid organ transplantation: a Bayesian network analysis
Yu Zhang1, Tao Zhou1, Mingzhu Huang1
1Department of Liver Surgery and Liver Transplantation Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Road, Pudong New District, Shanghai, 200 127, China.
Background:
Cytomegalovirus infection is one of the most common complications after solid organ transplantation. There have been several classes of antiviral drugs for the prevention of cytomegalovirus infection, such as acyclovir, valacyclovir, ganciclovir and valganciclovir.
Methods:
We searched relevant prospective and multi-armed studies on PubMed from Jan. 1984 up to Mar. 2018.
Results:
Seventeen prospective studies involving 2062 patients were included in the analysis. In the case of cytomegalovirus infection, the ganciclovir group (OR = 0.24, 95% CI 0.09-0.57) and the valacyclovir group (OR = 0.20, 95% CI 0.04-0.69) provided significantly better outcomes than the control group. The ganciclovir (OR = 0.37, 95% CI 0.13-0.86) and valacyclovir groups (OR = 0.31, 95% CI 0.07-0.98) showed moderate superiority compared to the acyclovir group. As for cytomegalovirus disease, the ganciclovir, valacyclovir and valganciclovir groups showed significant advantages compared with the control group (ganciclovir group: OR = 0.17, 95% CI 0.07-0.31, valacyclovir group: OR = 0.08, 95% CI 0.01-0.33, valganciclovir group: OR = 0.14, 95% CI 0.02-0.45). Similarly, the ganciclovir group (OR = 0.38, 95% CI 0.12-0.71) and the valacyclovir group (OR = 0.17, 95% CI 0.03-0.72) showed better results than the acyclovir group.
Conclusion:
Valacyclovir showed to be the most efficient antiviral for the prevention of cytomegalovirus infection and disease. Additional studies are required to evaluate putative side effects associated with valacyclovir administration.
Insights
Valacyclovir is the most effective antiviral for preventing cytomegalovirus infection and disease in transplant patients. Further research is needed to assess potential side effects of valacyclovir.
Area of Science:
- Transplantation Medicine
- Infectious Diseases
- Pharmacology
Background:
- Cytomegalovirus (CMV) infection is a significant post-transplant complication.
- Antiviral prophylaxis is crucial for managing CMV post-solid organ transplantation.
- Existing antivirals include acyclovir, valacyclovir, ganciclovir, and valganciclovir.
Purpose of the Study:
- To evaluate the efficacy of different antiviral agents in preventing CMV infection and disease.
- To compare the effectiveness of valacyclovir, ganciclovir, valganciclovir, and acyclovir.
- To identify the optimal antiviral strategy for CMV prophylaxis in transplant recipients.
Main Methods:
- Systematic review and meta-analysis of prospective, multi-armed studies.
- Literature search conducted on PubMed from January 1984 to March 2018.
- Inclusion of 17 studies with a total of 2062 patients.
Main Results:
- Valacyclovir and ganciclovir significantly reduced CMV infection compared to controls.
- Valacyclovir and ganciclovir demonstrated superiority over acyclovir for CMV infection prevention.
- Ganciclovir, valacyclovir, and valganciclovir showed significant advantages in preventing CMV disease compared to controls.
Conclusions:
- Valacyclovir emerges as the most effective antiviral for preventing both CMV infection and disease.
- Further investigation into the side effect profile of valacyclovir is warranted.
- Evidence supports valacyclovir as a primary choice for CMV prophylaxis in solid organ transplant recipients.
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