1. Association between Antiviral Prophylaxis and Cytomegalovirus and Epstein–Barr Virus DNAemia in Pediatric Recipients of Allogeneic Hematopoietic Stem Cell Transplant
- Author
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Helen Trottier, Nancy Robitaille, Louise Laporte, Geoffrey D.E. Cuvelier, Suzanne Vercauteren, Chantal Buteau, Michel Duval, Ndeye Soukeyna Diop, Pascal Roland Enok Bonong, Philip C. Spinella, Jacques Lacroix, Marisa Tucci, Victor Lewis, and Caroline Alfieri
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medicine.medical_specialty ,medicine.medical_treatment ,Immunology ,Congenital cytomegalovirus infection ,Hematopoietic stem cell transplantation ,Article ,Epstein–Barr virus ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,hemic and lymphatic diseases ,Drug Discovery ,medicine ,Pharmacology (medical) ,Cumulative incidence ,cytomegalovirus ,Pharmacology ,business.industry ,Proportional hazards model ,Hazard ratio ,antiviral prophylaxis ,virus diseases ,Famciclovir ,medicine.disease ,human herpesvirus ,Infectious Diseases ,pediatric ,030220 oncology & carcinogenesis ,Cohort ,hematopoietic stem cell transplantation ,Medicine ,business ,030215 immunology ,medicine.drug ,Cohort study - Abstract
Background: Epstein–Barr virus (EBV) and cytomegalovirus (CMV) infections can have serious consequences during the period of aplasia and lymphopenia following hematopoietic stem cell transplantation (HSCT). Large pediatric cohort studies examining the effect of antiviral prophylaxis against these viruses are scarce. The present study aimed to analyse the potential effect of antiviral prophylaxis (acyclovir and famciclovir) on active post-transplant EBV and CMV infection in a pediatric cohort of allogeneic HSCT recipients. Methods: We used data from the TREASuRE cohort, consisting of 156 patients who had a first allogeneic HSCT, enrolled in four pediatric centers in Canada between July 2013 and March 2017. Follow-up was performed from the time of transplant up to 100 days post-transplant. Adjusted hazard ratio (HR) with 95% confidence intervals (CI) for the association between antiviral prophylaxis with acyclovir and/or famciclovir and EBV and CMV DNAemia was estimated using multivariate Cox regression models. Results: The post-transplant cumulative incidence of EBV and CMV DNAemia at 100 days of follow-up were, respectively, 34.5% (95% CI: 27.6–42.6) and 19.9% (95% CI: 14.5–27.1). For acyclovir, the adjusted hazard ratio (HR) for CMV and EBV DNAemia was 0.55 (95% CI: 0.24–1.26) and 1.41 (95% CI: 0.63–3.14), respectively. For famciclovir, the adjusted HR were 0.82 (95% CI: 0.30–2.29) and 0.79 (95% CI: 0.36–1.72) for CMV and EBV DNAemia, respectively. Conclusion: The antivirals famciclovir and acyclovir did not reduce the risk of post-transplant CMV and EBV DNAemia among HSCT recipients in our pediatric population.
- Published
- 2021
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