Prophylactic treatment of ganciclovir to prevent and cure cytomegalovirus infection after renal transplantation: a systematic review / 复旦学报（医学版）

ABSTRACT

Objective To assess the efficacy of ganciclovir to prevent and cure cytomegalovirus (CMV) infection after renal transplantation. Methods We searched PubMed, EMBASE, Cochrane Library, SCI, China Academic Journals Full-text Databases, Chinese Biomedical Literature Database, Chinese Scientific Journals Databases and Chinese Medical Association Journals to collect randomized controlled trials of ganciclovir to prevent and cure CMV infection after renal transplantation (up to June, 2009). Two reviewers extracted data independently using a designed extraction form. The quality of included trials was evaluated according to the Cochrane Handbook. RevMan 5.0 software was used for data analysis. Results Twelve randomized controlled trials were included. The results of meta-analysis showed that ①Compared with no receive antiviral agents, ganciclovir couldn't lower CMV infection rate and disease rate in 3 months and 6 months after renal transplantation, but could lower CMV disease rate in 12 months. The delay between transplantation and CMV infection was significantly longer. ②Either valaciclovir or ganciclovir could lower CMV infection rate and disease rate after renal transplantation, without statistical difference. ③Compared with acyclovir, ganciclovir could lower CMV disease rate in 6 months after renal transplantation. ④Compared with CMV-IgG and valganciclovir, ganciclovir didn't have statistical difference in decreasing CMV disease rate (P=0.93;P=0.14). Conclusions Longer prophylaxis by ganciclovior may prevent CMV infection after renal transplantation. Its curative effect is similar to valaciclovir, CMV-IgG and valganciclovir, but better than acyclovir.