sirolimus and Herpes-Zoster

Topics: Antibodies, Monoclonal; Basiliximab; Calcineurin Inhibitors; Creatinine; Drug Therapy, Combination; Everolimus; Follow-Up Studies; Graft Rejection; Heart Transplantation; Herpes Zoster; Humans; Immunosuppressive Agents; Kidney Diseases; Prednisone; Recombinant Fusion Proteins; Retrospective Studies; Sirolimus; Stomatitis, Herpetic; Tacrolimus; Virus Activation

In an earlier study, we compared the duration of kidney graft survival between two groups of recipients; one on triple (cyclosporine, prednisone and mycophenolate mofetil) and the other on quadruple (cyclosporine, prednisone, mycophenolate mofetil, and sirolimus) immunosuppressive therapy.. The aim of this study was to examine the impact of antiviral and statin therapy on graft longevity.. One hundred five kidney allograft recipients were preoperatively assessed for serological markers of infection with various viral agents. All patients were on a prophylactic antiviral regimen of acyclovir and gancyclovir. Seventeen patients were on a statin. Patients were monitored for viral infections and graft rejection or loss for period of 3 years posttransplantation.. We detected a high preoperative prevalence rate of IgG immunoglobulins versus the latency-establishing Herpesviridae viruses. Two patients who were preoperatively IgG positive for CMV had cytomegalovirus disease after transplantation. One patient who was preoperatively IgG positive for VZV had shingles after the surgery. No other confirmed viral infections were reported. Thirteen of 88 patients (14.77%) whose treatment regimen did not include a statin suffered a rejection episode or lost the graft whereas 1 of 17 patients (5.88%) on a statin had a rejection episode.. The low rate of viral infections observed in our study population supports the utility of prophylactic administration of antiviral agents to transplant recipients. However, statins seem to have a protective effect on graft longevity (odds ratio [OR] = 0.361, 95% confidence interval [CI] = 0.044-2.957).

Topics: Adult; Anti-Inflammatory Agents; Antiviral Agents; Cyclosporine; Cytomegalovirus; Cytomegalovirus Infections; Female; Graft Rejection; Graft Survival; Herpes Zoster; Herpesvirus 3, Human; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Immunosuppressive Agents; Kidney Transplantation; Male; Middle Aged; Mycophenolic Acid; Prednisolone; Sirolimus; Transplantation, Homologous