Antiviral medications to prevent cytomegalovirus disease and early death in recipients of solid-organ transplants: a systematic review of randomised controlled trials.

摘要: Summary Background Antiviral prophylaxis is commonly used in recipients of solid-organ transplants with the aim preventing clinical syndrome associated cytomegalovirus infection. We undertook a systematic review to investigate whether this approach affects risks disease and death. Methods Randomised controlled trials antiviral medications for solid-organ-transplant were identified. Data combined meta-analyses by random-effects model. Findings Compared placebo or no treatment, aciclovir, ganciclovir, valaciclovir significantly reduced (19 trials, 1981 patients; relative risk 0·42 [95% CI 0·34–0·52]), infection (17 1786 0·61 [0·48–0·77]), all-cause mortality 1838 0·63 [0·43–0·92]), mainly owing lower from (seven 1300 0·26 [0·08–0·78]). Prophylaxis also lowered caused herpes simplex zoster virus, bacterial infections, protozoal but not fungal infection, acute rejection, graft loss. Meta-regression showed significant difference organ transplanted serostatus; conclusions possible cytomegalovirus-negative negative organs. In direct comparisons, ganciclovir was more effective than aciclovir disease. Valganciclovir intravenous as oral ganciclovir. Interpretation reduces transplants. This should be routinely cytomegalovirus-positive organs positive virus.