Risk of cytomegalovirus infection in solid organ transplant recipients: A population-based cross-sectional study

Relative to healthy individuals, in severely immunocompromised transplant recipients, the presentation of cytomegalovirus (CMV) is characterized by delayed clearance, more recurrent episodes, and faster changes in their condition over time. This study investigates CMV occurrence in solid organ transplantation (SOT) recipients, addressing a gap in epidemiological research.

Using National Health Insurance Research Database data, a cross-sectional study observed SOT recipients (2003-2019) with propensity score matching. The case group was 11,028 SOT recipients and 44,112 patients with chronic kidney disease (CKD) as the comparison. Logistic regression, adjusting for sex, age, insured salary, urbanization, and comorbidities, estimated CMV risk in a 3-year follow-up. Sensitivity analysis was performed to compare the risk of CMV at different follow-up periods (6-month, 1-year, and 2-year follow-up).

At 3-year follow-up, SOT recipients exhibited a higher CMV risk (aOR: 57.14, 95 % CI: 39.51-82.63) than CKD patients. Risks persisted at 6 months (aOR: 89.53, 95 % CI: 47.24-169.68), 1 year (aOR: 54.11, 95 % CI: 48.94-144.54), and 2 years (aOR: 62.82, 95 % CI: 41.71-94.61). In subgroup analysis, lung transplant recipients had the highest risk (aOR: 177.98, 95 % CI: 79.41-399.75), followed by kidney (aOR: 75.97, 95 % CI: 52.33-110.27) and liver transplant recipients (aOR: 31.44, 95 % CI: 20.78-47.50).

CMV risk persists post-SOT, peaking at 6 months. Lung transplant recipients face the highest risk, trailed by kidney and liver recipients.