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.