Gomes Neto, A.W. (2014) De invloed van patiëntenkarakteristieken en immuunsuppressief beleid op de immuunrespons tegen het cytomegalovirus in niertransplantatiepatienten. thesis, Medicine.
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Abstract
Cytomegalovirusinfection is the most common viral infection in renal transplant patients. In these patients infection with cytomegalovirus can result in severe disease accompanied by tissue-invasive disease. Secondly infection with cytomegalovirus is associated with an increased risk of mortality, rejection of the graft and opportunistic co-infections in these patients. Due to the lifelong latency of the virus in the human body an effective immune response is necessary for continuous control and suppression of the virus. In this study we retrospectively studied the effect of patientcharacteristics and immunosuppressive treatment on the immune response to primary cytomegalovirusinfection after renal transplantation. Between the first of July 2007 and the first of January 2014 855 patients received a renal transplant in the UMCG. Primary cytomegalovirusinfection occurred in 89 of the 855 patients. Cox-regression analysis showed that the duration until an IgM-response against cytomegalovirus after infection is shorter in women compared to man(HR 0.538 BI 0.333-0.868, p=0.011), is longer in HLA-Cw3 positive patients(HR 0.991 BI 0.985-0.997 p=0.004). Furthermore the chance of IgM-response occurrence against the cytomegalovirus increases by reduction of mycofenolic acid. Based on these results we suggest protocol implementation of early reduction of mycofenolic acid next to antiviral treatment in patients who develop a primary cytomegalovirusinfection after renal transplantation.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Son, Prof. W.J. van |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:03 |
| Last Modified: | 25 Jun 2020 11:03 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2315 |
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