Pre-emptive treatment for cytomegalovirus viraemia to prevent cytomegalovirus disease in solid organ transplant recipients

摘要: Background Cytomegalovirus (CMV) is a significant cause of morbidity and mortality in solid organ transplant recipients. Preemptive treatment with antiviral agents patients CMV viremia has been widely adopted as an alternative to routine prophylaxis prevent disease. This study was conducted evaluate the efficacy preemptive preventing symptomatic Methods The Cochrane CENTRAL Registry, MEDLINE, EMBASE, reference lists were searched for randomized trials Two authors extracted all data; analysis random effects model results expressed relative risk (RR) 95% confidence intervals (CI). Results Ten eligible (476 patients) identified, six versus placebo or standard care (treatment when disease occurred), three one oral intravenous treatment. Compared care, significantly reduced (6 trials, 288 patients, RR 0.29, CI 0.11 0.80) but not acute rejection (3 185 1.06, 0.64 1.76) all-cause (2 176 1.23, 0.35 4.30). Comparative therapy showed no difference risks 151 0.42, 0.07 2.65), (1 trial, 70 0.94, 0.42 2.09) 1.86, 0.61 5.72). Conclusions Few have evaluated effective compared additional head-to-head are required determine benefits harms