Adjuvant therapy of cytomegalovirus IgM + ve associated biliary atresia: Prima facie evidence of effect
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In brief
In brief
Study evaluates adjuvant antiviral therapy (ganciclovir/valganciclovir) in CMV-IgM positive biliary atresia patients following Kasai portoenterostomy. CMV-associated BA presents with greater inflammation and worse outcomes; this prospective analysis compares jaundice clearance and native liver survival between treated and untreated cohorts from 2003-2017.
Written by the GCMD Library team from the article.
Aim of study
CMV-IgM + ve associated biliary atresia (CMV-BA) is a distinct etiological subgroup characterized by older age at presentation and a greater degree of inflammation and hepatic fibrosis, leading to a worse outcome. We report our experience with adjuvant antiviral therapy after Kasai portoenterostomy (KPE).
Methods
Single-center prospective database identification of CMV-IgM + ve associated BA managed between 2003 and 2017. Since 2011, IV ganciclovir (5 mg/kg b.d.) and/or oral valganciclovir (520 mg/m2 b.d.) were started in the early postoperative period in selected cases and continued until negativity of CMV DNA load [Anti-Viral Therapy (AVT) Group 1]. Clearance of jaundice was defined as achieving a total bilirubin ≤20 μmol/L in post-KPE period and tested with a Fisher test; native liver survival (NLS) and overall actuarial survival (OS) were compared with untreated BA CMV IgM + ve patients (Group 2) using a Log-Rank test. A P value of