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Longer Antiviral Therapy Reduces Lung Transplant Complications

Study finds 12-month course of valganciclover wards off dangerous CMV infections

MONDAY, June 14 (HealthDay News) -- Extended antiviral treatment after a lung transplant may help prevent dangerous complications and organ rejection, a new study from Duke University Medical Center shows.

A common cause of infection in lung transplant recipients is cytomegalovirus (CMV), which often causes mild effects but can be life-threatening for transplant patients. Standard preventive therapy involves taking the drug valganciclovir (Valcyte) for up to three months. But even with this treatment, most lung transplant patients develop CMV infections within a year.

The Duke study included 136 patients who completed three months of oral valganciclovir and then received either an additional nine months of placebo (66 patients) or an additional nine months of oral valganciclovir (70 patients). Since it was a double-blind, placebo-controlled randomized study, researchers compared two groups of randomly selected patients at 11 different centers (one group of which received the additional medication and a control group that received the placebo, with neither the researchers nor the participants knowing who was in the control group).

Researchers found that CMV infection occurred in 10 percent of the extended treatment group, compared to 64 percent of the placebo group. Pneumonia caused by CMV virus occurred in 4 percent of the extended-treatment group and in 32 percent of the placebo group.

"We found that 12 months of oral valganciclovir was extremely effective and led to a dramatic reduction in the rate of CMV infection and disease," Dr. Scott Palmer, scientific director of the Lung Transplant Program at Duke University Medical Center, said in a university news release.

Potential side effects of valganciclovir include nausea, diarrhea, anemia and other blood disorders, retinal detachment, headache, fever, vomiting, mental changes and other problems. However, the study "showed that there was no increased or added toxicity with the extended course of treatment," Palmer said.

"In addition, the study examined viral resistance mutations and demonstrated that extended therapy did not lead to increased drug resistance, a potential concern with longer courses of treatment," Palmer added.

The study, published in the June 15 issue of the Annals of Internal Medicine, was funded by Roche Pharmaceuticals, which makes Valcyte.

More information

The American Academy of Family Physicians has more about CMV.

-- Robert Preidt

SOURCE: Duke Medicine, June 14, 2010. news release.

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