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08-07-2010 | Respiratory | Article

Cytomegalovirus pneumonitis increases risk for BOS in lung transplant patients

Abstract

Free abstract

MedWire News: Cytomegalovirus pneumonitis affects around a fifth of lung transplant patients and is associated with an increased risk for bronchiolitis obliterans syndrome (BOS) and death, research shows.

Writing in the American Journal of Respiratory and Critical Care Medicine, Laurie Snyder and colleagues from Duke University Medical Center in Durham, North Carolina, USA, explain: "Cytomegalovirus pneumonitis is one of the most prevalent opportunistic infections after lung transplantation."

They add: "In the era of routine prophylaxis and ganciclovir treatment, the adverse impact of treated cytomegalovirus pneumonitis on BOS has been challenged."

To investigate whether cytomegalovirus pneumonitis is associated with adverse outcomes in the current antiviral era, the researchers studied data from 231 patients who underwent lung transplantation at a single center between 2000 and 2004. All the participants received antiviral treatment with ganciclovir.

Bronchial biopsies revealed that 49 (21%) patients developed cytomegalovirus pneumonitis an average of 106 days after transplantation.

Analysis revealed that patients treated for cytomegalovirus pneumonitis within the first 6 months after transplantation were 2.19 times more likely to develop BOS than those without the infection.

Cytomegalovirus pneumonitis within the first 6 months after transplantation was also associated with a 1.89-fold increased risk for post-transplantation death.

The increased BOS and mortality risks associated with cytomegalovirus pneumonitis infection remained after accounting for age, comorbid conditions, and other risk factors, the researchers note.

Snyder and team conclude: "Cytomegalovirus pneumonitis affects more than 20% of lung transplant recipients [and] despite treatment, it increases the risk for BOS and death."

They add: "More effective preventive strategies for cytomegalovirus pneumonitis are needed to improve long-term outcomes after lung transplantation."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

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