Low-Dose Valacyclovir Effective for CMV Prophylaxis

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Low-dose valacyclovir prophylaxis reduces the incidence of cytomegalovirus (CMV) disease in CMV-negative renal transplant recipients who receive a renal allograft from a CMV-infected donor, new findings suggest. It also results in high patient and graft survival rates.

The researchers, led by Fredrik Sund, MD, PhD, of Uppsala University in Uppsala, Sweden, noted that 8 g/day of valacyclovir has been used as prophylaxis, but neurotoxic adverse effects have limited the use of this regimen. The aim of their study was to evaluate a valacyclovir prophylactic regimen of 3 g/day for 90 days after transplantation in 102 CMV-negative recipients who received a donor from a CMV-positive donor.

CMV disease was diagnosed in 25% of patients, and 2% experienced tissue-invasive CMV disease, Dr. Sund's group reported online in Nephrology Dialysis Transplantation. The rejection frequency was 22% and neurotoxic adverse effects were observed in 2% of patients. The five-year patient and graft survival rates were approximately 90% and 80%, respectively. These rates are comparable to those observed among 3,904 European kidney transplant recipients (excluding those in the Uppsala cohort) enrolled in the large international Collaborative Transplant Study.

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