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Comment & Response
September 15, 2020

Preemptive Therapy vs Antiviral Prophylaxis in Cytomegalovirus-Seronegative Liver Transplant Recipients With Seropositive Donors

Author Affiliations
  • 1Division of Infectious Diseases, Massachusetts General Hospital, Boston
  • 2Department of Pharmacy, Massachusetts General Hospital, Boston
JAMA. 2020;324(11):1107-1108. doi:10.1001/jama.2020.11862

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?

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