DOAJ Open Access 2024

CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant Recipients

Isabelle Eberl Christine Binquet Christine Binquet Adrien Guilloteau Mathieu Legendre +11 lainnya

Abstrak

Pneumocystis pneumonia (PcP) remains life-threatening in kidney transplant recipients (KTR). Our study investigated risk factors one-year before PcP. We conducted a monocentric, case-control study including all KTR at the Dijon University Hospital (France) with a diagnosis of PcP between 2005 and 2022 (cases), and matched control KTR with no history of PcP (3 controls/case). Among all 1,135 KTR, 57 cases (5%) and 169 matched-controls were included. PcP was associated with 18% mortality. Compared to controls, cases were older, with a higher immunological risk, and CMV infection was more frequent in the year preceding the occurrence of PcP (23% vs. 4%; p < 0.001). As early as 1 year before PcP, lymphocyte counts were lower and serum creatinine levels were higher in cases, but immunosuppressive regimens were not significantly different. Multivariable analysis identified lymphocyte count, serum creatinine level, being treated by immunosuppressive therapy other than anti-rejection drugs, and CMV infection in the year preceding the time PcP as independently associated with the occurrence of PcP. PcP was associated with an increased risk of subsequent chronic rejection (27% vs. 3%; p = 0.001) and return to dialysis (20% vs. 3%; p = 0.002). The occurrence of CMV infection and a low lymphocyte count could redefine the indications for continuation or reinitiation of anti-Pneumocystis prophylaxis.

Penulis (16)

I

Isabelle Eberl

C

Christine Binquet

C

Christine Binquet

A

Adrien Guilloteau

M

Mathieu Legendre

F

Frederic Dalle

F

Frederic Dalle

L

Lionel Piroth

L

Lionel Piroth

L

Lionel Piroth

C

Claire Tinel

C

Claire Tinel

M

Mathieu Blot

M

Mathieu Blot

M

Mathieu Blot

M

Mathieu Blot

Format Sitasi

Eberl, I., Binquet, C., Binquet, C., Guilloteau, A., Legendre, M., Dalle, F. et al. (2024). CMV Infection and Lymphopenia: Warning Markers of Pneumocystis Pneumonia in Kidney Transplant Recipients. https://doi.org/10.3389/ti.2024.12192

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Informasi Jurnal
Tahun Terbit
2024
Sumber Database
DOAJ
DOI
10.3389/ti.2024.12192
Akses
Open Access ✓