Barten Markus J, Baldanti Fausto, Staus Alexander, Hüber Christian M, Glynou Kyriaki, Zuckermann Andreas
Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, 20246 Hamburg, Germany.
Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
Life (Basel). 2022 Mar 2;12(3):361. doi: 10.3390/life12030361.
Cytomegalovirus (CMV) is a common infection occurring in patients undergoing solid organ transplantation (SOT) or hematopoietic stem cell transplantation (HSCT). CMV-specific hyperimmunoglobulin (CMVIG) has been used for the past four decades and is typically administered either prophylactically or pre-emptively. The present meta-analysis evaluated CMV infection rates in SOT patients who received prophylactic CMVIG. PubMed and the Cochrane Library were searched for studies published up to October 2021. The primary endpoint was CMV infection rate. Thirty-two SOT studies were identified (n = 1521 CMVIG-treated and n = 1196 controls). Prophylactic CMVIG treatment was often associated with a lower risk of CMV infection in transplant recipients. The average CMV infection rate was 35.8% (95% confidence interval [CI]: 33.4−38.2%) in patients treated prophylactically with CMVIG and 41.4% (95% CI: 38.6−44.2%) in the control group not receiving CMVIG (p = 0.003). Similar results were observed in analyses limited to publications evaluating currently available CMVIG products (Cytotect CP and Cytogam; p < 0.001). In combination with the established safety profile for CMVIG, these results suggest that prophylactic CMVIG treatment in patients undergoing solid organ transplantation may be beneficial, particularly in those at high risk of CMV infection or disease.
巨细胞病毒（CMV）感染在接受实体器官移植（SOT）或造血干细胞移植（HSCT）的患者中很常见。在过去的四十年里，CMV特异性高效价免疫球蛋白（CMVIG）一直被使用，通常用于预防性或抢先性治疗。本荟萃分析评估了接受预防性CMVIG治疗的SOT患者的CMV感染率。检索了PubMed和Cochrane图书馆中截至2021年10月发表的研究。主要终点是CMV感染率。共纳入32项SOT研究（1521例接受CMVIG治疗，1196例为对照组）。预防性CMVIG治疗通常与移植受者较低的CMV感染风险相关。接受预防性CMVIG治疗的患者平均CMV感染率为35.8%（95%置信区间[CI]：33.4−38.2%），未接受CMVIG的对照组为41.4%（95%CI：38.6−44.2%）（p = 0.003）。在仅限于评估目前可用的CMVIG产品（Cytotect CP和Cytogam）的出版物分析中也观察到了类似结果（p < 0.001）。结合CMVIG已确立的安全性，这些结果表明，实体器官移植患者接受预防性CMVIG治疗可能有益，特别是对于那些有CMV感染或疾病高风险的患者。
