Clinical values of preemptive therapy versus universal prophylaxis in the prevention of cytomegalovirus infection post kidney transplantation: a systematic review and Meta-analysis
10.3760/cma.j.issn.1000-6702.2018.04.013
- VernacularTitle:肾移植术后抢先治疗和普遍预防对预防巨细胞病毒感染的Meta分析
- Author:
Lei WANG
1
;
Guizhu PENG
;
Qifa YE
Author Information
1. 430071 武汉大学中南医院,武汉大学肝胆疾病研究院,武汉大学移植医学中心,移植医学技术湖北省重点实验室
- Keywords:
Kidney transplantation;
Cytomegalovirus infection;
Preemptive therapy;
Universal prophylaxis;
Meta-analysis
- From:
Chinese Journal of Urology
2018;39(4):294-299
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy of preemptive therapy versus universal prophylaxis in prevention of cytomegalovirus (CMV) infection post kidney transplantation.Methods Databases including the PubMed,EMbase,sinoMed,Web of Knowledge,the Cochrane Central Register of Controlled Trails (CENTRAL) and other databases were searched up to December 2016 for controlled clinical studies which involved preemptive therapy and universal prophylaxis.Odds ratio (OR) and mean difference (MD) with 95％ confidence interval (CI) was performed using Review Manager 5.3 software to synthesize the results.Results 11 studies with a total of 2 560 patients were included in this Metaanalysis.Results showed that universal prophylaxis was superior to preemptive therapy in the total CMV infection and CMV disease(OR =3.38,95％ CI 2.13-5.36,P ＜0.001;OR =1.69,95％ CI 1.14-2.48,P =0.008),otherwise it was on the contrary in the late onset CMV infection and CMV disease (OR =0.07,95％ CI0.02 ～0.19,P ＜ 0.001;OR =0.08,95％ CI 0.01-0.60,P =0.01).However,there was no significance in the short outcomes between the two groups including 1-year recipient and graft survival and renal function.In addition,preemptive therapy was superior to universal prophylaxis in the adverse events (OR =0.33,95 ％ CI 0.15-0.72,P =0.006).Conclusions There was no significant difference between the two prophylaxis in the prevention of CMV infection,but preemptive therapy was superior to universal prophylaxis in the prevention of anti-virus adverse effects.
