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Clinical Study of Risk Factors for Early Human Cytomegalovirus Reactivation Following Liver Transplantation
Yanyue Zhang1, Genyong Gui2, Xiaopeng Yu2
1Department of Clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua Municipal Central Hospital Medical Group, Jinhua, China.
Background:
Human cytomegalovirus (HCMV) is the most common opportunistic infection following liver transplantation (LT). This study aimed to identify risk factors for HCMV reactivation early post-transplantation.
Methods:
We retrospectively analyzed data from 150 LT recipients aged ≥14 years who received preemptive therapy in China from July 2017 to December 2018. We performed univariate and multivariate analyses to identify risk factors for HCMV reactivation within the first 90 days post-transplantation.
Results:
HCMV reactivation occurred in 32 patients (21.33%) within the first 90 days post-LT. Intensive care unit length of stay (odds ratio [OR], 1.055; 95% confidence interval [CI], 1.007-1.104; P = .023), fungal infections (OR, 3.093; 95% CI, 1.092-8.764; P = .034), and non-hepatitis B virus (HBV)-related liver disease (OR, 5.576; 95% CI, 2.137-14.552; P = .000) were significant risk factors for HCMV reactivation within the first 90 days post-LT. The cumulative incidence of HCMV reactivation was significantly higher in patients with non-HBV-related liver diseases (P = .0007) than in those with HBV-related liver diseases. In the former, HCMV reactivation early after transplantation was associated with the pretransplantation hepatitis B surface antibody (HBsAb) serological status (P = .006). Higher HBsAb titers were significantly associated with reduced HCMV reactivation risk (P = .011).
Conclusions:
This study suggested that HCMV is a common opportunistic infection early after LT. Reducing intensive care unit lengths of stay and preventing fungal infections may reduce the risk of HCMV reactivation early after transplantation. Pretransplantation HBsAb titers might be a useful predictor in patients with non-HBV-related liver diseases.
