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. 2023 Jan 10:10:1085101.
doi: 10.3389/fped.2022.1085101. eCollection 2022.

Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation

Elodie Cheyssac  1 , Hamidou Savadogo  2 , Nathan Lagoutte  2 , Véronique Baudouin  1 , Marina Charbit  3 , Robert Novo  4 , Anne-Laure Sellier-Leclerc  5 , Marc Fila  6 , Stéphane Decramer  7 , Elodie Merieau  8 , Ariane Zaloszyc  9 , Jérôme Harambat  10 , Gwenaelle Roussey  2
Affiliations

Valganciclovir is not associated with decreased EBV infection rate in pediatric kidney transplantation

Elodie Cheyssac et al. Front Pediatr. .

Abstract

Introduction: Primary infection or reactivation of Epstein-Barr Virus (EBV) is a significant cause of morbidity and mortality in pediatric kidney transplantation. Valganciclovir (VGC) treatment is recommended for prophylaxis of cytomegalovirus infection, but its role for the prevention of EBV infection remains controversial.

Patients and methods: All pediatric kidney transplant recipients aged <18 years old were considered for inclusion in this retrospective study. EBV negative recipients with an EBV positive donor (a group at risk of primary infection) or EBV positive recipients (a group at risk of reactivation) were included. Severe infection was defined by post-transplant lymphoproliferative disorder (PTLD), symptomatic EBV infection or by asymptomatic EBV infection with a viral load >4.5 log/ml. Outcomes were compared between patients receiving VGC prophylaxis (group P+) and those not receiving VGC prophylaxis (group P-).

Results: A total of 79 patients were included, 57 (72%) in the P+ group and 22 (28%) in the P- group; 25 (31%) were at risk of primary infection and 54 (69%) at risk of reactivation. During the first year post-transplant, the occurrence of severe EBV infection was not different between the P+ group (n = 13, 22.8%) and the P- group (n = 5, 22.7%) (p = 0.99). Among patients at risk of primary infection, the rate of severe EBV infection was not different between the two groups (42.1% in P+ vs. 33.3% in P-). A higher frequency of neutropenia was found in the P+ group (66.6%) than in the P- group (33.4%) (p < 0.01).

Conclusion: Our observational study suggests no effect of VGC for the prevention of EBV infection in pediatric kidney transplant recipients, irrespective of their EBV status. Adverse effects revealed an increased risk of neutropenia.

Keywords: Epstein–Barr virus; PTLD; pediatric kidney transplantation; prophylaxis; valganciclovir.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
Survival without severe EBV infection according to valganciclovir prophylaxis.
Figure 3
Figure 3
Survival without EBV infection according to valganciclovir prophylaxis.
See this image and copyright information in PMC

References

    1. Dharnidharka VR, Fiorina P, Harmon WE. Kidney transplantation in children. N Engl J Med. (2014) 371:549–58. 10.1056/NEJMra1314376 - DOI - PubMed
    1. Vanichanan J, Udomkarnjananun S, Avihingsanon Y, Jutivorakool K. Common viral infections in kidney transplant recipients. Kidney Res Clin Pract. (2018) 37:323–37. 10.23876/j.krcp.18.0063 - DOI - PMC - PubMed
    1. Smith JM, Dharnidharka VR. Viral surveillance and subclinical viral infection in pediatric kidney transplantation. Pediatr Nephrol. (2015) 30:741–8. 10.1007/s00467-014-2866-8 - DOI - PMC - PubMed
    1. Verghese PS, Schmeling DO, Knight JA, Matas AJ, Balfour HH. Valganciclovir administration to kidney donors to reduce the burden of cytomegalovirus and epstein barr virus transmission during transplantation. Transplantation. (2015) 99:1186–91. 10.1097/TP.0000000000000490 - DOI - PubMed
    1. Cohen JI. Epstein-Barr virus infection. N Engl J Med. (2000) 343:481–92. 10.1056/NEJM200008173430707 - DOI - PubMed

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