Assessment of Cytomegalovirus Status and Risk Stratification in Renal Transplant Recipients in Mexico: A Real-World Study
Author(s)
Ignacio Juarez, MD1, Luis García-Covarrubias, MD2, Thales Jose Polis, MD3, Carla Fabrine Carvalho, MSc4, Daniela Vicentini, PharmD4, JULIA LIMA, MSc4, Felipe Zottino Nazareth, PharmD4, Felype Castelhano, Student3, Juan C. Orengo, MPH, PhD, MD5, Cintia Irene Parellada, MD, PhD3.
1Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán., Ciudad de México, Mexico, 2Hospital de Especialidades Dr. Bernardo Sepúlveda Gutierrez, Ciudad de México, Mexico, 3MSD Brazil, São Paulo, Brazil, 4Oracle Do Brasil Sistemas Ltda., São Paulo, Brazil, 5MSD (IA) LLC, San Juan, PR, USA.
1Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán., Ciudad de México, Mexico, 2Hospital de Especialidades Dr. Bernardo Sepúlveda Gutierrez, Ciudad de México, Mexico, 3MSD Brazil, São Paulo, Brazil, 4Oracle Do Brasil Sistemas Ltda., São Paulo, Brazil, 5MSD (IA) LLC, San Juan, PR, USA.
Presentation Documents
OBJECTIVES: Cytomegalovirus (CMV) is a significant cause of morbidity and mortality in renal transplant (RT) recipients. This study aims to assess the CMV status and establish risk stratification for CMV disease in RT recipients post-transplant in Mexico, which is crucial for effective management and prevention strategies.
METHODS: A retrospective chart-review study was conducted in Mexico between January 2019 and June 2021. Data were collected from two hospitals, including patients ≥ 18 years old who underwent RT and had CMV serostatus confirmed by specific serologic tests prior to transplantation. Pre-transplant CMV risk was categorized into three groups: high risk (donor CMV positive, recipient negative), intermediate risk (donor either positive or negative; and recipient positive), and low risk (both CMV negative). Post-transplant, patients were monitored for CMV using PCR; those with a viral load ≥ 4000 units/mL were classified as having an active infection.
RESULTS: Among 101 patients analyzed, 59.4% were male (n=60) and 40.6% female (n=41). Pre-transplant risk stratification revealed 10.9% (n=11) were categorized as high risk, 84.2% (n=85) as intermediate risk, and 4.9% (n=5) as low risk for CMV disease. Post-transplant, 30.7% (n=31) of patients reached the viral load threshold for active CMV infection, 66.3% (n=67) did not and 3% (n=3) had no data available. For prevention, 28.7% (n=29) used valganciclovir prophylactically and one patient used preemptive measures.
CONCLUSIONS: This study provides valuable insights related to pre and post-transplant CMV diagnosis assessments and risk stratification of RT recipients in Mexico. Despite the majority being classified as intermediate risk for CMV, the low utilization of preventive strategies highlights a critical gap in post-transplant care. Enhancing awareness and implementation of prophylactic measures could significantly reduce CMV-related morbidity and mortality in this population.
METHODS: A retrospective chart-review study was conducted in Mexico between January 2019 and June 2021. Data were collected from two hospitals, including patients ≥ 18 years old who underwent RT and had CMV serostatus confirmed by specific serologic tests prior to transplantation. Pre-transplant CMV risk was categorized into three groups: high risk (donor CMV positive, recipient negative), intermediate risk (donor either positive or negative; and recipient positive), and low risk (both CMV negative). Post-transplant, patients were monitored for CMV using PCR; those with a viral load ≥ 4000 units/mL were classified as having an active infection.
RESULTS: Among 101 patients analyzed, 59.4% were male (n=60) and 40.6% female (n=41). Pre-transplant risk stratification revealed 10.9% (n=11) were categorized as high risk, 84.2% (n=85) as intermediate risk, and 4.9% (n=5) as low risk for CMV disease. Post-transplant, 30.7% (n=31) of patients reached the viral load threshold for active CMV infection, 66.3% (n=67) did not and 3% (n=3) had no data available. For prevention, 28.7% (n=29) used valganciclovir prophylactically and one patient used preemptive measures.
CONCLUSIONS: This study provides valuable insights related to pre and post-transplant CMV diagnosis assessments and risk stratification of RT recipients in Mexico. Despite the majority being classified as intermediate risk for CMV, the low utilization of preventive strategies highlights a critical gap in post-transplant care. Enhancing awareness and implementation of prophylactic measures could significantly reduce CMV-related morbidity and mortality in this population.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
SA69
Topic
Study Approaches
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Infectious Disease (non-vaccine)