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Nephrol Dial Transplant (1999) 14: 2304-2308
© 1999 European Renal Association-European Dialysis and Transplant Association

Invited Comments

Prophylaxis of cytomegalovirus infection in renal transplantation: new data for an old problem

Dirk R. J. Kuypers and Yves F. Ch. Vanrenterghem

Department of Nephrology and Renal Transplantation, Universitaire Ziekenhuizen Leuven, Leuven, Belgium

Correspondence and offprint requests to: Dirk Kuypers, Department of Nephrology and Renal Transplantation, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.

Keywords: acute allograft rejection; cytomegalovirus; ganciclovir; prophylaxis; renal transplantation; valacyclovir

Introduction

New reports in the literature about the effective use of valacyclovir (Zelitrex°, Valtrex°, Glaxo Wellcome) as prophylactic treatment for cytomegalovirus (CMV) infection in renal transplantation, have prompted us to update our recent Editorial Comment (Nephrol Dial Transplant 13: 3012–3016, 1998) on this interesting topic. Valacyclovir not only reduces the incidence of active CMV infection and CMV disease in renal transplant patients, but it also seems to exert a beneficial effect on the incidence of acute allograft rejection, other herpesvirus infections and non-viral infections.

These additional properties of valacyclovir warrant a critical analysis of the published data in the light of the old and new available information about ganciclovir prophylaxis in renal transplantation.

Valacyclovir trials

Valacyclovir is an amino acid ester prodrug of acyclovir that is rapidly and almost completely hydrolysed to acyclovir and has an oral bioavailability of 54% compared to 20% for acyclovir. The plasma AUC of acyclovir attained with . . . [Full Text of this Article]

Ganciclovir trials

Conclusion

Acknowledgments

References


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