Pre-transplant cytomegalovirus (CMV) exposure and post-transplant CMV replication contribute to an elevated risk of cardiovascular events in kidney transplant recipients, according to investigators.

Cécile Courivaud, MD, of Saint Jacques Hospital in Besançon, France, and colleagues studied 570 renal transplant recipients (RTR) who had a follow-up of 87 months. Of these, 357 were considered to be CMV-exposed and 213 were considered to be CMV-naïve. CMV exposure was independently associated with an 80% increased risk for atherosclerotic events (AE). The 213 CMV-naïve patients remained CMV negative for the entire study period, 225 CMV-positive patients had no replication after transplantation, and 132 experienced CMV replication after transplantation. AE rates for these three groups were 8.5%, 13.3%, and 18.2%, respectively. Patients who experienced CMV replication post-transplantation had a significant twofold increased risk of AE and a significant 76% increased risk of death compared with CMV-negative recipients, Dr. Courivaud’s group reported online ahead of print in the Journal of Infectious Diseases.

“If CMV replication is a risk factor for post-transplant atherosclerotic events, one can speculate that primary prevention, and not pre-emptive treatment, of CMV infection would reduce the rate of cardiovascular events in RTR,” the authors concluded.

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