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Valcyte lowers CMV infection recurrence rate in LT recipients

The use of Valcyte for the treatment of cytomegalovirus infection in liver transplant recipients resulted in a lower incidence of cytomegalovirus recurrence vs. recipients who were treated with cytovene, according to study data.

Researchers assigned 83 liver transplant recipients with cytomegalovirus (CMV) infection from Samsung Medical Center in Korea dosages of either 900 mg of Valcyte (valganciclovir hydrochloride, Hoffmann La Roche) daily or 5 mg/kg of Cytovene (ganciclovir, Roche Palo) twice daily as preemptive treatment for the infection. Sixty-one patients received ganciclovir for antiviral therapy and 22 patients received valganciclovir.

Overall, the patients treated with valganciclovir had a lower CMV infection recurrence rate compared with patients treated with ganciclovir (4.5% vs. 14.8%; P = .277), respectively.  MELD score, Child-Pugh class C, hepatorenal syndrome and deceased donor liver transplantation were higher in the patients with CMV infection compared to patients without CMV infection. The MELD score was higher in the patients who received valganciclovir compare with patients who received ganciclovir. However, there was no significant differences in the pre-transplant variables between the two groups, according to the research.

One-year and 2-year survival rates among the patients who received ganciclovir were similar to those who received valganciclover (95.5% vs. 83.6%; 86.8% vs. 83.6%, respectively). No significant differences in survival were observed between the two groups (P = .365).

Aspartate aminotransferase, alanine aminotransferase and total bilirubin levels were higher among patients who received ganciclovir compared with patients who received valganciclovir when CMV infection occurred, due to the fact that only patients with stable liver graft received valganciclovir for preemptive treatment, according to the research.  

“Our results demonstrate that oral [valganciclovir] is equally effective in preemptive treatment of CMV infection following liver transplantation,” the researchers concluded. “Patients in the oral [valganciclovir] group had stable liver graft function, and our study does not necessarily suggest the conclusion that oral valganciclovir] is effective as a preemptive treatment in all liver transplant recipients. However, the present study demonstrated that oral [valganciclovir] may prevent CMV disease in an outpatient setting and thereby reduce patient burden and health care costs.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.