Clinical Study of Risk Factors for Early Human Cytomegalovirus Reactivation Following Liver Transplantation

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2026-05-01 Epub Date: 2026-04-20 DOI:10.1016/j.transproceed.2026.03.007

Yanyue Zhang , Genyong Gui , Xiaopeng Yu , Jun Fan , Xiaoping Pan

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引用次数: 0

Abstract

Background

Human cytomegalovirus (HCMV) is the most common opportunistic infection following liver transplantation (LT). This study aimed to identify risk factors for HCMV reactivation early post-transplantation.

Methods

We retrospectively analyzed data from 150 LT recipients aged ≥14 years who received preemptive therapy in China from July 2017 to December 2018. We performed univariate and multivariate analyses to identify risk factors for HCMV reactivation within the first 90 days post-transplantation.

Results

HCMV reactivation occurred in 32 patients (21.33%) within the first 90 days post-LT. Intensive care unit length of stay (odds ratio [OR], 1.055; 95% confidence interval [CI], 1.007-1.104; P = .023), fungal infections (OR, 3.093; 95% CI, 1.092-8.764; P = .034), and non-hepatitis B virus (HBV)-related liver disease (OR, 5.576; 95% CI, 2.137-14.552; P = .000) were significant risk factors for HCMV reactivation within the first 90 days post-LT. The cumulative incidence of HCMV reactivation was significantly higher in patients with non-HBV-related liver diseases (P = .0007) than in those with HBV-related liver diseases. In the former, HCMV reactivation early after transplantation was associated with the pretransplantation hepatitis B surface antibody (HBsAb) serological status (P = .006). Higher HBsAb titers were significantly associated with reduced HCMV reactivation risk (P = .011).

Conclusions

This study suggested that HCMV is a common opportunistic infection early after LT. Reducing intensive care unit lengths of stay and preventing fungal infections may reduce the risk of HCMV reactivation early after transplantation. Pretransplantation HBsAb titers might be a useful predictor in patients with non-HBV-related liver diseases.

查看原文本刊更多论文

肝移植术后早期巨细胞病毒再激活危险因素的临床研究。

背景：人巨细胞病毒（HCMV）是肝移植术后最常见的机会性感染。本研究旨在确定移植后早期HCMV再激活的危险因素。方法：我们回顾性分析了2017年7月至2018年12月在中国接受先发制人治疗的150名年龄≥14岁的肝移植受体的数据。我们进行了单变量和多变量分析，以确定移植后90天内HCMV再激活的危险因素。结果：32例患者（21.33%）在肝移植后90天内发生HCMV再激活。重症监护室住院时间（优势比[OR]， 1.055； 95%可信区间[CI]， 1.007-1.104; P = 0.023）、真菌感染（OR, 3.093; 95% CI, 1.092-8.764; P = 0.034）和非乙型肝炎病毒（HBV）相关肝病（OR, 5.576; 95% CI, 2.137-14.552; P = 0.000）是肝移植后90天内HCMV再激活的重要危险因素。非hbv相关肝病患者的HCMV再激活累积发生率显著高于hbv相关肝病患者（P = 0.0007）。在前者中，移植后早期HCMV再激活与移植前乙肝表面抗体（HBsAb）血清学状态相关（P = 0.006）。高HBsAb滴度与降低HCMV再激活风险显著相关（P = 0.011）。结论：本研究提示移植后早期HCMV是一种常见的机会性感染。减少重症监护病房的住院时间和预防真菌感染可能降低移植后早期HCMV再激活的风险。移植前HBsAb滴度可能是非hbv相关肝病患者的有用预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.