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. 2024 May 15;229(5):1435-1439.
doi: 10.1093/infdis/jiad386.

Cytomegalovirus Viral Load Threshold to Guide Preemptive Therapy in Hematopoietic Cell Transplant Recipients: Correlation With Cytomegalovirus Disease

Alicja Sadowska-Klasa  1   2 , Wendy M Leisenring  1 , Ajit P Limaye  1   3 , Michael Boeckh  1   3
Affiliations

Cytomegalovirus Viral Load Threshold to Guide Preemptive Therapy in Hematopoietic Cell Transplant Recipients: Correlation With Cytomegalovirus Disease

Alicja Sadowska-Klasa et al. J Infect Dis. .

Abstract

A systematic review of randomized and observational studies from 2013 to 2023 demonstrated that antiviral preemptive therapy started at cytomegalovirus viral load thresholds between 2 and 3 log10 IU/mL was associated with similar cytomegalovirus disease rates. Thus, viral thresholds in this range appear to effectively protect patients not receiving prophylaxis.

Keywords: CMV; CMV disease; preemptive therapy; review; viral load threshold.

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Conflict of interest statement

Potential conflicts of interest. A. P. L. has received research support from Merck and Takeda; served as a consultant for GSK, Vera, AiCuris, Merck, and Moderna; and served on a data safety and monitoring board for Novartis, Syneos, and Nobelpharma. M. B. received research support from Merck and served as a consultant for Allovir, Symbio Pharmaceuticals, Moderna, and Merck. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Correlation between the incidence of cytomegalovirus (CMV) disease at 100 days and viral load (VL) thresholds. For the 5 studies that provided different thresholds for low-risk and high-risk populations (Table 1), we assessed the use of either threshold. The lower VL thresholds used for high-risk patients (A) and the higher thresholds used for low-risk patients (B) were uniformly applied. Red dots represent randomized controlled trials; black dots, observational studies; dashed line, the linear regression line. Abbreviation: NS, not significant.
See this image and copyright information in PMC

References

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