Burden of Cytomegalovirus DNAemia among Pediatric Renal Transplant Patients on Antiviral Prophylaxis: A Hospital-Based Analysis
Bibliographic record
Abstract
Cytomegalovirus (CMV) is a major cause for concern among transplant patients. Some pediatric centers employ a prevention strategy with antiviral prophylaxis and polymerase chain reaction (PCR) to monitor for CMV DNAemia in the post-transplant period. This study examines the burden of CMV DNAemia and time to such events among renal transplant patients within the first year after transplantation. We conducted a retrospective review of renal transplant patients (<18 years) who were transplanted between January 2007 and December 2012. Patients who were CMV donor-seropositive (D+) and recipient seronegative (R-) received prophylaxis with ganciclovir (IV) for 2 weeks followed by valganciclovir or oral acyclovir for 10 weeks and low-risk (D+R+ or D-R+) patients received valganciclovir for 12 weeks, with modifications based on age and clinical status. Clinical and laboratory data were obtained from the medical records and laboratory databases. Among 121 patients, the median age at transplant was 12.6 years (range 6 months–17.8 years); M:F ratio 1:0.57. Forty-two patients (34.7%) received anti-T-cell globulins. CMV serostatus: D+R- 27 (23.1%); D-R+ and D+R+ 35 (29.9%) and D-R- 55 (47%). CMV DNAemia was detected in 18 patients (14.8%) during the first post-transplant year. Among these patients, 8 were D+R- and 8 were D-R+ or D+R+. Median time to first positivity was 134 days (range 0–188 days). Among patients whose first positive PCR was after 3 months post-transplant, median time to positivity was 53 days (range 32–98 days) after the end of prophylaxis. CMV DNAemia while on prophylaxis was uncommon, occurring 1 in 40 transplanted patients. Routine monitoring while on prophylaxis may be no longer warranted. Studies are needed to determine the optimal indications for CMV PCR testing while on prophylaxis. All authors: No reported disclosures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".