To the Editor Dr Singh and colleagues1 reported that within the first 12 months after liver transplantation, preemptive therapy resulted in significantly lower rates of cytomegalovirus (CMV) disease compared with primary valganciclovir prophylaxis in 205 CMV-seronegative recipients from seropositive donors. The authors noted that a 1-patient difference in each group would have nullified this outcome. The study reported 2 cases of CMV disease in the prophylaxis group (usually rare), potentially due to inadequate kidney dosing; while this highlights the importance of appropriate dosing, would the outcome have been different had these 2 cases not occurred?
Roberts MB, Gandhi RG, Kotton CN. Preemptive Therapy vs Antiviral Prophylaxis in Cytomegalovirus-Seronegative Liver Transplant Recipients With Seropositive Donors. JAMA. 2020;324(11):1107–1108. doi:10.1001/jama.2020.11862
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