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. 2024 Mar 20;78(3):719-722.
doi: 10.1093/cid/ciad643.

Association of Cytomegalovirus (CMV) DNAemia With Long-Term Mortality in a Randomized Trial of Preemptive Therapy and Antiviral Prophylaxis for Prevention of CMV Disease in High-Risk Donor Seropositive, Recipient Seronegative Liver Transplant Recipients

Lakshin Kumar  1 , Sayan Dasgupta  2 , Cristina Murray-Krezan  3 , Nina Singh  4 , Robert M Rakita  1 , Cynthia E Fisher  1 , Ajit P Limaye  1
Affiliations

Association of Cytomegalovirus (CMV) DNAemia With Long-Term Mortality in a Randomized Trial of Preemptive Therapy and Antiviral Prophylaxis for Prevention of CMV Disease in High-Risk Donor Seropositive, Recipient Seronegative Liver Transplant Recipients

Lakshin Kumar et al. Clin Infect Dis. .

Abstract

In a post-hoc analysis of the association of CMV DNAemia with long-term mortality in a randomized trial of CMV preemptive therapy vs. antiviral prophylaxis in D+R- liver transplant recipients, post-intervention CMV DNAemia was associated with increased mortality after adjusting for study arm.

Keywords: antiviral therapy; cytomegalovirus; immunocompromised host; liver transplant; viral infections.

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Conflict of interest statement

Potential conflicts of interest. A. P. L. is a consulting and/or site investigator for and has received institutional payments from Merck & Co, GlaxoSmithKline, Moderna, and Takeda Pharmaceuticals; has received institutional support via consulting fees from AiCures and Vera Therapeutics; reports consulting fees from Merck & Co, Moderna, AlloVir, and GlaxoSmithKline; and was reimbursed for participation on a data and safety monitoring board for Novartis, Syneos, and NobelPharma. C. E. F. is a consulting and/or site investigator holding grants or contracts unrelated to the study for Moderna and Amplyx Pharmaceuticals, Inc; has received support from National Institutes of Health (NIH); reports honoraria from NIH for serving as a VIDD study section ad hoc member; has received travel reimbursement from NIH; and was an unpaid participant of the United Network for Organ Sharing Disease Transmission Advisory Committee. C. M. K. has received institutional funding support unrelated to this article from the NIH, Patient-Centered Outcomes Research Institute (PCORI), and University of New Mexico; was reimbursed for travel expenses for participation on a clinical trials advisory panel for PCORI; and has received honoraria for leadership positions as chair for the PCORI Clinical Trials Advisory Panel and co-chair for the Membership Committee of the Society for Clinical Trials. S. D. has received institutional support from NIH (National Cancer Institute/National Institute of Allergy and Infectious Disease), University of Washington, Gilead Sciences, Inc, and Merck & Co and employee travel support from the Fred Hutchinson Cancer Center. 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

Graphical Abstract
Graphical Abstract
This graphical abstract is also available at Tidbit: https://tidbitapp.io/tidbits/association-of-cmv-dnaemia-with-long-term-mortality-in-a-randomized-trial-of-preemptive-therapy-pet-and-antiviral-prophylaxis-ap-for-prevention-of-cmv-disease-in-high-risk-donor-seropositive-recipient-se-2480b1a4-e573-43a6-973b-94ea264eed04
Figure 1.
Figure 1.
Comparisons of mortality in participants who completed the intervention period and late-onset CMV DNAemia in donor-seropositive, recipient-seronegative liver transplant recipients. A, Kaplan–Meier survival curve of participant who survived and completed the assigned intervention. B, Kaplan–Meier survival curve of participants who survived to 12 months post-transplant. C, Comparison of percent of participants who developed CMV DNAemia at 6 months and 12 months post-transplant. Analysis was limited to participants who survived to 12 months post-transplant. D, Violin plots of CMV DNAemia showing distribution of log10 (CMV viral load) at 6 and 12 months post-transplant in participants who survived to 12 months post-transplant. Abbreviations: CMV, cytomegalovirus; PET, preemptive therapy; tx, treatment.
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