Journal Article

Comparison of Intravenous Ganciclovir Followed by Oral Acyclovir with Intravenous Ganciclovir Alone for Prevention of Cytomegalovirus and Epstein- Barr Virus Disease After Liver Transplantation in Children

Michael Green, Mark Kaufmann, John Wilson and Jorge Reyes

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 6, pages 1344-1349
Published in print December 1997 | ISSN: 1058-4838
Published online December 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516139
Comparison of Intravenous Ganciclovir Followed by Oral Acyclovir with Intravenous Ganciclovir Alone for Prevention of Cytomegalovirus and Epstein- Barr Virus Disease After Liver Transplantation in Children

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A randomized trial was performed to compare the sequential use of 2 weeks of intravenous ganciclovir (10 mg/[kgrd]) followed by 50 weeks of high-dose oral acyclovir (800 mg/m2 four times daily) with 2 weeks of intravenous ganciclovir alone as prophylaxis for cytomegalovirus (CMV) and Epstein-Barr virus (EBV) disease after pediatric liver transplantation. CMV disease was diagnosed for seven of 24 patients treated with ganciclovir followed by high-dose oral acyclovir compared with two of 24 children treated with ganciclovir alone (P = 048). Similarly, the rate of CMV disease among high-risk patients (CMV-positive donor/CMV-negative recipient) treated with the combination regimen was higher than that among high-risk patients treated with ganciclovir alone (four [57%] of seven vs. zero of five, respectively; vs P < .05). The rate of EBV disease among patients treated with the combination regimen (eight [33%] of 24) was similar to that among patients treated with ganciclovir alone (five [21%] of 24; P = not significant). We conclude that sequential prophylaxis with 2 weeks of intravenous ganciclovir followed by 50 weeks of high-dose oral acyclovir did not decrease the frequency of CMV or EBV disease after pediatric liver transplantation when compared with 2 weeks of intravenous ganciclovir alone.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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