ArticleJournal of the American Society of Nephrology : JASN2009
Six-month prophylaxis is cost effective in transplant patients at high risk for cytomegalovirus infection.
Article in Journal of the American Society of Nephrology : JASN, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 62 citations in OpenAlex.
- Cost-effectiveness of Preemptive Therapy Versus Prophylaxis in a Randomized Clinical Trial for the Prevention of Cytomegalovirus Disease in Seronegative Liver Transplant Recipients With Seropositive Donors.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Trial
- First World Consensus Conference on pancreas transplantation: Part II - recommendations.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Prospective Study of Long Noncoding RNA, MGAT3-AS1, and Viremia of BK Polyomavirus and Cytomegalovirus in Living Donor Renal Transplant Recipients.Kidney international reports · 2020Article
- Role of Secondary Prophylaxis With Valganciclovir in the Prevention of Recurrent Cytomegalovirus Disease in Solid Organ Transplant Recipients.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Renal association clinical practice guideline in post-operative care in the kidney transplant recipient.BMC nephrology · 2017Article
- Cytomegalovirus disease in patients with glomerular diseases treated by immunosuppressive treatment.International urology and nephrology · 2014Article
- Cytomegalovirus disease in African-American kidney transplant patients.Transplant infectious disease : an official journal of the Transplantation Society · 2012Article
- Cytomegalovirus in the transplanted kidney: a report of two cases and review of prophylaxis.NDT plus · 2011Article
- Efficacy and safety of a lower-dose valganciclovir (valcyte) regimen for cytomegalovirus prophylaxis in kidney and pancreas transplant recipients.P & T : a peer-reviewed journal for formulary management · 2010Article
- Management of cytomegalovirus infection in solid organ transplantation.Nature reviews. Nephrology · 2010Review
- Cytomegalovirus prophylaxis: how long is enough?Nature reviews. Nephrology · 2010Article
- Use of leflunomide in renal transplant recipients with ganciclovir-resistant/refractory cytomegalovirus infection: a case series from the University of Chicago.Case reports in nephrology and dialysisArticle
- Face allotransplantation and burns: a review.Journal of burn care & research : official publication of the American Burn AssociationReview
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The risk of late-onset cytomegalovirus (CMV) infection remains a concern in seronegative kidney and/or pancreas transplant recipients of seropositive organs despite the use of antiviral prophylaxis. The optimal duration of prophylaxis is unknown. We studied the cost effectiveness of 6- versus 3-mo prophylaxis with valganciclovir. A total of 222 seronegative recipients of seropositive kidney and/or pancreas transplants received valganciclovir prophylaxis for either 3 or 6 mo during two consecutive time periods. We assessed the incidence of CMV infection and disease 12 mo after completion of prophylaxis and performed cost-effectiveness analyses. The overall incidence of CMV infection and disease was 26.7% and 24.4% in the 3-mo group and 20.9% and 12.1% in the 6-mo group, respectively. Six-month prophylaxis was associated with a statistically significant reduction in risk for CMV disease (HR, 0.35; 95% CI, 0.17 to 0.72), but not infection (HR, 0.65; 95% CI, 0.37 to 1.14). Cost-effectiveness analyses showed that 6-mo prophylaxis combined with a one-time viremia determination at the end of the prophylaxis period incurred an incremental cost of $34,362 and $16,215 per case of infection and disease avoided, respectively, and $8,304 per one quality adjusted life-year gained. Sensitivity analyses supported the cost effectiveness of 6-mo prophylaxis over a wide range of valganciclovir and hospital costs, as well as variation in the incidence of CMV disease. In summary, 6-mo prophylaxis with valganciclovir combined with a one-time determination of viremia is cost effective in reducing CMV infection and disease in seronegative recipients of seropositive kidney and/or pancreas transplants.
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