Associations between invasive aspergillosis and cytomegalovirus in lung transplant recipients: a nationwide cohort study

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Cytomegalovirus (CMV) and invasive aspergillosis (IA) cause morbidity among lung transplant recipients (LTXr). Early diagnosis and treatment could improve outcomes. We examined rates of CMV after IA and vice versa to assess whether screening for one infection is warranted after detecting the other. All Danish LTXr, 2010–2019, were followed for IA and CMV for 2 years after transplantation. IA was defined using ISHLT criteria. Adjusted incidence rate ratios (aIRR) were estimated by Poisson regression adjusted for time after transplantation. We included 295 LTXr, among whom CMV and IA were diagnosed in 128 (43%) and 48 (16%). The risk of CMV was high the first 3 months after IA, IR 98/100 person-years of follow-up (95% CI 47–206). The risk of IA was significantly increased in the first 3 months after CMV, aIRR 2.91 (95% CI 1.32–6.44). Numbers needed to screen to diagnose one case of CMV after IA, and one case of IA after CMV was approximately seven and eight, respectively. Systematic screening for CMV following diagnosis of IA, and vice versa, may improve timeliness of diagnosis and outcomes for LTXr.
OriginalsprogEngelsk
TidsskriftAPMIS
Vol/bind131
Udgave nummer11
Sider (fra-til)574-583
ISSN0903-4641
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
The study was supported by the Danish National Research Foundation, grant #126.

Funding Information:
CGC, SMW, JHL, PB, and JL declare no conflict of interest outside nor directly related to the study. MH has participated in advisory boards for AstraZeneca, Gilead, GSK, Jansen, MSD, Roche, and Sobi and declares no conflict of interest directly related to the study. MCA has, over the past 5 years, received research grants/contract work (paid to the SSI) from Amplyx, Basilea, Cidara, F2G, Gilead, Novabiotics and Scynexis, and speaker honoraria (personal fee) from Astellas, Chiesi, Gilead, MSD, and SEGES. She is the current chairman of the EUCAST‐AFST and declares no conflict of interest directly related to the study. MP has participated in advisory boards for Takeda, and PulmonX. Served as a research consultant for AMBU. Received an unlimited institutional research grant from Roche and travel grants from Boehringer Ingelheim. Received lecturing honorary from AstraZeneca, GSK, Therakos and PulmonX but declares no conflict of interest directly related to the study.

Publisher Copyright:
© 2023 The Authors. APMIS published by John Wiley & Sons Ltd on behalf of Scandinavian Societies for Pathology, Medical Microbiology and Immunology.

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