Can Viral Load be used as a Surrogate Marker in Clinical Studies of #Cytomegalovirus in Solid Organ #Transplantation: A Systematic Review and Meta-analysis
https://academic.oup.com/cid/article-abstract/doi/10.1093/cid/cix793/4104615/Can-Viral-Load-be-used-as-a-Surrogate-Marker-in?redirectedFrom=fulltext
We found several lines of evidence to support the validity of viral load as an appropriate surrogate end-point including 1)viral loads in CMV disease are significantly greater than in asymptomatic viremia (OR 9.3, 95%CI 4.6 to 19.3); 2)kinetics of viral replication are strongly associated with progression to disease; 3)pooled incidence of CMV viremia and disease is significantly lower during prophylaxis compared with the full patient followup period (viremia incidence: 3.2%vs.34.3%, p<0.001) (disease incidence: 1.1%vs.13.0%, p<0.001); 4)treatment of viremia prevented disease; and 5)viral load decline correlated with symptom resolution. Based on the analysis, we conclude that CMV viral load is an appropriate surrogate end-point for CMV trials in organ transplant recipients
https://academic.oup.com/cid/article-abstract/doi/10.1093/cid/cix793/4104615/Can-Viral-Load-be-used-as-a-Surrogate-Marker-in?redirectedFrom=fulltext
We found several lines of evidence to support the validity of viral load as an appropriate surrogate end-point including 1)viral loads in CMV disease are significantly greater than in asymptomatic viremia (OR 9.3, 95%CI 4.6 to 19.3); 2)kinetics of viral replication are strongly associated with progression to disease; 3)pooled incidence of CMV viremia and disease is significantly lower during prophylaxis compared with the full patient followup period (viremia incidence: 3.2%vs.34.3%, p<0.001) (disease incidence: 1.1%vs.13.0%, p<0.001); 4)treatment of viremia prevented disease; and 5)viral load decline correlated with symptom resolution. Based on the analysis, we conclude that CMV viral load is an appropriate surrogate end-point for CMV trials in organ transplant recipients
OUP Academic
Can Viral Load be used as a Surrogate Marker in Clinical Studies of Cytomegalovirus in Solid Organ Transplantation: A Systematic…
Symptomatic CMV disease has been the standard endpoint for clinical trials in organ transplant recipients. Viral load may be a more relevant endpoint due to low frequency of disease. We performed a meta-analysis and systematic review of the literature. We…
!!
#Cytomegalovirus – an unrecognised potential contributor to #cystic fibrosis disease progression?
https://erj.ersjournals.com/content/early/2019/01/16/13993003.01727-2018
Cytomegalovirus (CMV) is a common human beta-herpes virus most notable for causing visceral disease in profoundly immune-suppressed populations, and congenital infections. However, an increasing body of work has demonstrated that CMV seropositivity is associated with a number of chronic medical conditions including heart disease and dementia – potentially related to the effects of chronic inflammation.
We hypothesided that the outcomes of individuals with cystic fibrosis (CF), a chronic inflammatory disease, could similarly be associated with CMV-status. We performed a single-centre retrospective study of all 71 individuals with CF referred for lung transplantation from our CF centre between 1991–2017 and assessed how CMV serostatus associated with patient pre-transplant outcomes.
We observed CMV IgG positivity was associated with disproportionate progression to end-stage lung disease as defined by death/or transplantation in our cohort (27.2 versus 35.1 years, difference 7.95 which remained significant following adjustment for confounders . CMV may represent a potentially important modifier of CF lung disease, warranting further study
#Cytomegalovirus – an unrecognised potential contributor to #cystic fibrosis disease progression?
https://erj.ersjournals.com/content/early/2019/01/16/13993003.01727-2018
Cytomegalovirus (CMV) is a common human beta-herpes virus most notable for causing visceral disease in profoundly immune-suppressed populations, and congenital infections. However, an increasing body of work has demonstrated that CMV seropositivity is associated with a number of chronic medical conditions including heart disease and dementia – potentially related to the effects of chronic inflammation.
We hypothesided that the outcomes of individuals with cystic fibrosis (CF), a chronic inflammatory disease, could similarly be associated with CMV-status. We performed a single-centre retrospective study of all 71 individuals with CF referred for lung transplantation from our CF centre between 1991–2017 and assessed how CMV serostatus associated with patient pre-transplant outcomes.
We observed CMV IgG positivity was associated with disproportionate progression to end-stage lung disease as defined by death/or transplantation in our cohort (27.2 versus 35.1 years, difference 7.95 which remained significant following adjustment for confounders . CMV may represent a potentially important modifier of CF lung disease, warranting further study
!!
Detection of #Cytomegalovirus in Intestinal Tissue of Infants with #Necrotizing #Enterocolitis or Spontaneous Intestinal #Perforation
https://www.jpeds.com/article/S0022-3476(19)30890-X/fulltext?mobileUi=0
To determine the frequency of detection of cytomegalovirus (CMV) in surgical or autopsy intestinal tissue from infants with necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) of the small bowel.
CMV was detected by PCR or IHC in 7 (4%) of 178 infants with surgical or autopsy- confirmed NEC (n = 6) or SIP (n = 1). Among 143 NEC cases (123 surgical, 20 autopsy), CMV was detected in 6 (4%): 4 (2 surgical, 2 autopsy) by both PCR and IHC, and 2 (surgical) by PCR only. Among 35 SIP cases (32 surgical, 3 autopsy), 1 (3%) surgical case was positive, by PCR only. CMV-associated NEC cases had lower median gestational age, birth weight , and platelet count compared with CMV-negative cases, respectively. No association was found with receipt of maternal milk, age at NEC diagnosis, male sex, cholestasis, or mortality.
CMV was detected in intestinal tissue from 4% of NEC or SIP cases (NEC, 4%; SIP, 3%). Lower gestational age, lower birth weight, and thrombocytopenia were significantly associated with detection of CMV in NEC or SIP cases
Detection of #Cytomegalovirus in Intestinal Tissue of Infants with #Necrotizing #Enterocolitis or Spontaneous Intestinal #Perforation
https://www.jpeds.com/article/S0022-3476(19)30890-X/fulltext?mobileUi=0
To determine the frequency of detection of cytomegalovirus (CMV) in surgical or autopsy intestinal tissue from infants with necrotizing enterocolitis (NEC) or spontaneous intestinal perforation (SIP) of the small bowel.
CMV was detected by PCR or IHC in 7 (4%) of 178 infants with surgical or autopsy- confirmed NEC (n = 6) or SIP (n = 1). Among 143 NEC cases (123 surgical, 20 autopsy), CMV was detected in 6 (4%): 4 (2 surgical, 2 autopsy) by both PCR and IHC, and 2 (surgical) by PCR only. Among 35 SIP cases (32 surgical, 3 autopsy), 1 (3%) surgical case was positive, by PCR only. CMV-associated NEC cases had lower median gestational age, birth weight , and platelet count compared with CMV-negative cases, respectively. No association was found with receipt of maternal milk, age at NEC diagnosis, male sex, cholestasis, or mortality.
CMV was detected in intestinal tissue from 4% of NEC or SIP cases (NEC, 4%; SIP, 3%). Lower gestational age, lower birth weight, and thrombocytopenia were significantly associated with detection of CMV in NEC or SIP cases