Utility of Oral Valganciclovir for Cytomegalovirus Prophylaxis: Does It Improve Treatment Compliance?

• Published in: Transplantation proceedings Vol. 40; no. 9; pp. 3063 - 3064
• Main Authors: Moro, J.A, Almenar, L, Martínez-Dolz, L, Blanes, M, Agüero, J, Sánchez-Lázaro, I, Salvador, A
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01.11.2008; Elsevier
• Subjects: Administration, Oral; Adult; Antiviral Agents - administration & dosage; Antiviral Agents - therapeutic use; Biological and medical sciences; Cohort Studies; Cytomegalovirus Infections - prevention & control; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Ganciclovir - administration & dosage; Ganciclovir - analogs & derivatives; Ganciclovir - therapeutic use; Humans; Infectious diseases; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Patient Compliance; Patient Selection; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Viral diseases; Opportunistic infection; Purine nucleoside; Valganciclovir; Herpesviridae; Oral administration; Transplantation; Prodrug; Betaherpesvirinae; Human cytomegalovirus; Infection; Virus; Medicine; Prevention; Improvement; Treatment; Surgery; Viral disease; Nucleoside analog; Antiviral; Graft; Treatment compliance; DNA polymerase inhibitor
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2008.09.052

Abstract Introduction Cytomegalovirus (CMV) infection is a significant cause of morbidity and mortality among heart transplant (HT) patients. Various prophylactic and preemptive treatment regimens have been used for its prevention. We sought to assess the impact of oral valganciclovir on CMV prophylaxis in HT patients. Patients and Methods A retrospective analysis of 536 consecutive HT patients at our institution allowed selection of subjects eligible for prophylaxis based on CMV serology (donor positive/recipient negative). Treatment compliance, rates of preemptive therapy and treatment for CMV disease were assessed according to prophylactic drug use. If the indication was present, treatment was considered to have been performed. Results Among 536 patients, 9.8% ( n = 53) were eligible for prophylaxis. Seventeen patients (33%) received valganciclovir, with a compliance rate of 94.1%. The remaining 68% received prophylaxis mainly with IV. ganciclovir (5 mg/kg) during their hospital stay followed by oral ganciclovir, with a compliance rate of 57.1% ( P = .01). No differences were observed when we analyzed the need for preemptive therapy (0 vs 7%; P = .28) or for treatment of systemic or organ-specific infection (6.3 vs 0%; 6.3 vs 14%, respectively; P = .8). Conclusion Oral valganciclovir facilitated treatment compliance in prophylaxis for CMV without being inferior to other prophylactic therapies.