Treatment of cytomegalovirus disease in solid organ transplant recipients

Rollag, H., Åsberg, A., Ueland, T., Hartmann, A., Jardine, A.G. , Humar, A., Pescovitz, M.D., Bignamini, A.A. and Aukrust, P. (2012) Treatment of cytomegalovirus disease in solid organ transplant recipients. Transplantation, 94(10), pp. 1060-1065. (doi: 10.1097/TP.0b013e31826c39de)

Abstract

Background: Treatment failure or relapse is common in solid organ transplant recipients treated for cytomegalovirus (CMV) disease. Because CMV infections induce a vigorous inflammatory response, we investigated whether pretreatment levels of inflammatory markers were associated with virologic and clinical outcomes. Methods: Solid organ transplant recipients enrolled in an international multicenter trial of CMV disease treatment (the VICTOR study) were studied (n=248). Plasma levels of markers of inflammation and endothelial cell activation were assessed at baseline and during follow-up by enzyme immunoassays. Results: Baseline values for the chemokine CXCL16 was an independent predictor of clinical outcome (P=0.003) and was a weak independent predictor of suppression of viral load below level of detection (LOD) (P=0.013) at day 21 after initiation of treatment. Baseline levels of the long pentraxin 3 (PTX3) was an independent predictor of suppression of viral load below LOD at day 21 (P=0.002), whereas baseline levels of von Willebrand factor (vWF) was an independent predictor of clinical outcome at day 21 (P=0.008), and vWF levels at day 21 was a weak independent inflammatory predictor of viral recurrence (P=0.018). Conclusions: The present study shows that the plasma levels of CXCL16, PTX3 and vWF at the start of treatment are independently associated with virologic and clinical treatment failure during anti-CMV therapy in solid organ transplant recipients. These findings suggest a link between CMV infection and inflammation that also may influence the outcome of anti-CMV therapy.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jardine, Professor Alan
• Authors: Rollag, H., Åsberg, A., Ueland, T., Hartmann, A., Jardine, A.G., Humar, A., Pescovitz, M.D., Bignamini, A.A., and Aukrust, P.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Transplantation
• ISSN: 0041-1337
• Published Online: 27 November 2012