| Domaine : |
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Sciences du Vivant/Microbiologie et Parasitologie
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| Titre : |
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High incidence of anticytomegalovirus drug resistance among D+R- kidney transplant recipients receiving preemptive therapy. |
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| Auteur(s) : |
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L. Couzi, S. Helou, T. Bachelet, K. Moreau, S. Martin1, D. Morel, M. E. Lafon, B. Boyer2, S. Alain3, I. Garrigue4, P. Merville |
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| Laboratoire : |
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| Résumé : |
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Anti-cytomegalovirus (CMV) prophylaxis is recommended in D+R- kidney transplant recipients (KTR), but is associated with a theoretical increased risk of developing anti-CMV drug resistance. This hypothesis was retested in this study by comparing 32 D+R- KTR who received 3 months prophylaxis (valganciclovir) with 80 D+R- KTR who received preemptive treatment. The incidence of CMV infections was higher in the preemptive group than in the prophylactic group (60% vs. 34%, respectively; p = 0.02). Treatment failure (i.e. a positive DNAemia 8 weeks after the initiation of anti-CMV treatment) was more frequent in the preemptive group (31% vs. 3% in the prophylactic group; p = 0.001). Similarly, anti-CMV drug resistance (UL97 or UL54 mutations) was also more frequent in the preemptive group (16% vs. 3% in the prophylactic group; p = 0.05). Antiviral treatment failures were associated with anti-CMV drug resistance (p = 0.0001). Patients with a CMV load over 5.25 log(10) copies/mL displayed the highest risk of developing anti-CMV drug resistance (OR = 16.91, p = 0.0008). Finally, the 1-year estimated glomerular filtration rate was reduced in patients with anti-CMV drug resistance (p = 0.02). In summary, preemptive therapy in D+R- KTR with high CMV loads and antiviral treatment failure was associated with a high incidence of anti-CMV drug resistance. |
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Langue du texte
intégral : |
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Anglais |
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| Journal : |
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| American Journal of Transplantation (Am J Transplant) |
| Publisher |
Wiley-Blackwell |
| ISSN |
1600-6135 (eISSN : 1600-6143) |
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| Audience : |
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internationale |
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| Type de publication : |
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Articles dans des revues avec comité de lecture |
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| Date de publication : |
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01/2012 |
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Date de publication
électronique : |
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03/10/2011 |
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| Volume : |
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12 |
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| Numéro : |
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1 |
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| Page, identifiant, ... : |
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202-9 |
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