Abstract
Respiratory tract infection with Pneumoviruses (PV) and Paramyxoviruses (PMV) are increasingly associated with chronic lung allograft dysfunction (CLAD) in lung transplant recipients (LTR). Ribavirin may be a treatment option but its effectiveness is unclear, especially with respect to infection severity. We retrospectively analyzed ten years of PV/PMV infections in LTR. Main endpoints were FEV1 at three and six months post-infection, expressed as a percentage of pre-infection FEV1 and incidence of new or progressed CLAD six months post-infection. A total of 139 infections were included; 88 (63%) severe infections (defined as >10% FEV1 loss at infection), 51 (37%) mild infections (≤10% FEV1 loss). Overall post-infection CLAD incidence was 20%. Associations were estimated on post-infection FEV1 for ribavirin vs. no ribavirin (+13.2% [7.79;18.67]) and severe vs. mild infection (-11.1% [-14.76; -7.37). Factors associated with CLAD incidence at six months were ribavirin treatment (OR 0.24 [0.10-0.59]), severe infection (OR 4.63 [1.66;12.88]) and mycophenolate mofetil use (OR 0.38 [0.14;0.97]). This data provides valuable information about the outcomes of lung transplant recipients with these infections and suggests possible associations of ribavirin use and infection severity with long-term outcomes. Well-designed prospective trials are needed to confirm these findings.
Original language | English |
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Pages (from-to) | 3529-3537 |
Number of pages | 9 |
Journal | American Journal of Transplantation |
Issue number | 12 |
Early online date | 2020 |
DOIs | |
Publication status | Published - 17-Jun-2020 |
Keywords
- antibiotic
- antiviral
- clinical research
- practice
- infection and infectious agents - viral
- infectious disease
- lung (allograft) function
- dysfunction
- lung transplantation
- pulmonology
- VIRAL-INFECTIONS
- ORAL RIBAVIRIN
- IN-VITRO
- EPIDEMIOLOGY
- OUTCOMES
- REPLICATION
- INHIBITION
- EFFICACY
- RISK