Cytomegalovirus infection in kidney transplant patients: Prevalence, risk factors, and impact on outcome – A local multicentre experience

• Published in: Transplant immunology Vol. 69; p. 101473
• Main Authors: Abou-Jaoudé, Maroun, El Hage, Said, Akiki, Dany, Fadlallah, Mahdi, Ghaith, Abdul-Karim, Dib, Abbas
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2021
• Subjects: Antiviral Agents - therapeutic use; Cytomegalovirus; Cytomegalovirus Infections - drug therapy; Cytomegalovirus Infections - epidemiology; Epidemiology; Humans; Immunosuppression; Incidence; Kidney transplant; Kidney Transplantation; Prevalence; Renal Dialysis; Retrospective Studies; Risk Factors; Transplant Recipients; Cytomegalovirus; Immunosuppression; Kidney transplant; Epidemiology; Risk factors
• ISSN: 0966-3274; 1878-5492
• DOI: 10.1016/j.trim.2021.101473

CMV infection prevalence in kidney transplant recipients (KTR) is reported to be high in the literature, reaching rates of over 80%. The primary endpoints were the evaluation of the prevalence, the risks factors, and the effects of CMV infection on graft function and survival, as well as patient survival at three years after kidney transplantation. We retrospectively reviewed the medical records of 288 kidney transplant patients operated in three Lebanese transplant centers between 1998 and 2017 with three years of follow-up. The patients were divided into two groups: those free of any CMV infection (271 patients (94%); Group I) and those who suffered from CMV infection (17 patients (6%); Group II). Baseline demographics of the two groups were similar, including recipient and donor gender and age, cause of renal disease, recipient body mass index, pre-transplant fasting blood sugar and dialysis duration, HLA matching between donor and recipient, degree of sensitization in the recipient, type of CMV prophylaxis, maintenance immunosuppression and immunological characteristics. The prevalence of CMV infection is 5.9% among KTR. There were significant differences between the two groups concerning the type of induction therapy and the duration of anti-CMV prophylaxis. The rate of infected patients and infectious episodes were significantly higher in Group II. At 3-years, graft function and survival, patient survival, and the rate of new-onset diabetes were similar between the two groups. The present study is the first to explore the incidence and risk factors of CMV in kidney transplant patients in Lebanon. Comprehensive nationwide studies are therefore necessary to determine the epidemiology and risk factors of CMV infection after kidney transplantation in Lebanon. •Sample of 288 kidney transplant recipients (KTR) was assessed for CMV disease prevalence and risk factors.•Prevalence of CMV disease in KTR was low (5.9%), compared to other studies.•Type of induction therapy and duration of anti-CMV prophylaxis were significant risk factors for CMV disease.•Age and gender of donor and recipient, HLA matching, degree of sensitization did not have significant effects on CMV disease.•Seronegative recipients receiving kidneys from seropositive patients were at highest risk of disease.•This is the first study in Lebanon to assess CMV epidemiology among KTR.