Martin-Gandul, CStampf, SHequet, DMueller, N JCusini, Avan-Delden, CKhanna, NBoggian, KHirzel, CSoccal, PHirsch, H HPascual, MMeylan, PManuel, O2023-01-252023-01-252017Martin-Gandul C, Stampf S, Héquet D, Mueller NJ, Cusini A, van Delden C, et al. Preventive Strategies Against Cytomegalovirus and Incidence of α-Herpesvirus Infections in Solid Organ Transplant Recipients: A Nationwide Cohort Study. Am J Transplant. 2017 Jul;17(7):1813-1822.http://hdl.handle.net/10668/10728We assessed the impact of antiviral preventive strategies on the incidence of herpes simplex virus (HSV) and varicella-zoster virus (VZV) infections in a nationwide cohort of transplant recipients. Risk factors for the development of HSV or VZV infection were assessed by Cox proportional hazards regression. We included 2781 patients (56% kidney, 20% liver, 10% lung, 7.3% heart, 6.7% others). Overall, 1264 (45%) patients received antiviral prophylaxis (ganciclovir or valganciclovir, n = 1145; acyclovir or valacyclovir, n = 138). Incidence of HSV and VZV infections was 28.9 and 12.1 cases, respectively, per 1000 person-years. Incidence of HSV and VZV infections at 1 year after transplant was 4.6% (95% confidence interval [CI] 3.5–5.8) in patients receiving antiviral prophylaxis versus 12.3% (95% CI 10.7–14) in patients without prophylaxis; this was observed particularly for HSV infections (3% [95% CI 2.2–4] versus 9.8% [95% CI 8.4–11.4], respectively). A lower rate of HSV and VZV infections was also seen in donor or recipient cytomegalovirus-positive patients receiving ganciclovir or valganciclovir prophylaxis compared with a preemptive approach. Female sex (hazard ratio [HR] 1.663, p = 0.001), HSV seropositivity (HR 5.198, p < 0.001), previous episodes of rejection (HR 1.95, p = 0.004), and use of a preemptive approach (HR 2.841, p = 0.017) were significantly associated with a higher risk of HSV infection. Although HSV and VZV infections were common after transplantation, antiviral prophylaxis significantly reduced symptomatic HSV infections.enantibiotic: antiviral-ganciclovir/valganciclovirclinical research/practiceinfection and infectious agentsinfectious diseaseviralviral: herpes zoster/VaricellaAdultAntiviral AgentsCohort StudiesCytomegalovirusCytomegalovirus InfectionsFemaleFollow-Up StudiesGraft RejectionGraft SurvivalHerpesviridae InfectionsHerpesvirus 3, HumanHumansIncidenceMaleMiddle AgedOrgan TransplantationPrognosisRisk FactorsSwitzerlandTransplant Recipientsresearch article28039960Restricted AccessInfeccionesAntiviralesIncidenciaHerpesvirus humano 3CitomegalovirusSimplexvirusValaciclovir10.1111/ajt.141921600-6143https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/ajt.14192