Styczynski J - Researchers here reported on the incidence of Cytomegalovirus (CMV) recurrence and CMV disease in groups of immunocompromised patients, including allogeneic hematopoietic stem cell transplantation (HSCT) patients. For this group of patients, they also investigated the risk factors for CMV recurrence and disease. Data indicated 3 risk factors: donor-negative (D-)/recipient-positive (R+) CMV serostatus, acute or chronic graft-versus-host disease, and unrelated donor/mismatched donor transplant. In addition, increased age was a risk factor, but it corresponded to the increasing CMV-seropositivity rate in the general population. The 3 risk factors needed to be considered as major risk factors. Regardless of early or late phase after allogeneic HSCT, all other factors should be regarded as minor risk factors.

• Estimations in HSCT recipients indicated that the median rate of CMV recurrence was 37% after allogeneic transplant and 12% after autologous transplant, 5% in patients with nontransplant hematological malignancies, 14% in recipients of anti-CD52 therapy, 30% in solid organ transplant recipients, 21% in patients with primary immunodeficiencies, 20% during active replication in HIV-positive patients and 3.3% during antiretroviral therapy, 7% in patients with chronic kidney disease, 0.6% in patients with congenital infection, and 0.6% in neonates with primary infection.
• Researchers reported the highest risk of CMV recurrence and CMV disease for HSCT CMV-seropositive recipients, regardless of donor serostatus.
• They observed higher odds ratio (OR) for CMV recurrence for recipient-positive vs recipient-negative CMV serostatus transplants (OR 8.0), donor-negative/recipient-positive vs donor-positive/recipient-positive CMV serostatus transplants (OR 1.2), unrelated/mismatched vs matched-family donor transplants (OR 1.6), and acute graft-versus-host-disease vs other diseases (OR 3.2).
• Other risk factors obtained had minor significance.