Cytomegalovirus prophylaxis with antiviral agents in solid organ transplantation - A meta-analysis

被引:76
作者
Couchoud, C
Cucherat, M
Haugh, M
Pouteil-Noble, C
机构
[1] Ctr Hosp Lyon Sud, Nephrol Transplantat Unit, F-69495 Pierre Benite, France
[2] Hospices Civils Lyon, Dept Clin Pharmacol, F-69394 Lyon 03, France
[3] Ctr Leon Berard, French Cochrane Ctr, F-69373 Lyon 08, France
关键词
D O I
10.1097/00007890-199803150-00007
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. The aim of this meta-analysis was to assess the efficacy of antiviral agents to prevent, in solid organ transplant recipients, cytomegalovirus infection and symptomatic disease and to decrease the incidence of acute rejection, graft loss, and death, Methods, Of the studies identified, 13 met the following inclusion criteria: prospective randomized study, in adults or pediatric recipients of a solid organ transplant, where one group in the study received a prophylactic treatment with acyclovir and/or ganciclovir begun before the cytomegalovirus infection and a control group was not treated or receive placebo. Results, Prophylactic treatment was found to be associated with a significant decrease of cytomegalovirus disease compared with placebo or no treatment, using the logarithm of relative risk method (relative risk=0.50; 95% confidence interval, 0.40-0.62; P-value for chi-square association <0.001). Prophylactic treatment decreased also the rate of cytomegalovirus infection (relative risk=0.74; 95% confidence interval, 0.62-0.88; P<0.001). Our analysis failed to show a significant decrease of graft loss, acute rejection, and death in the prophylactic treatment group. Subgroup analysis based on the type of antiviral agent (acyclovir or ganciclovir) and on the type of organ (kidney or liver) gave comparable results, Conclusion, The use of antiviral agents for the prevention of cytomegalovirus disease and cytomegalovirus infection in solid organ transplantation is supported by this meta-analysis.
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页码:641 / 647
页数:7
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