Objectives: To assess the risk factors for development of late-onset invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT).
Methods: We performed a multinational case-control study that retrospectively recruited 112 KT recipients diagnosed with IPA between 2000 and 2013. Controls were matched (1:1 ratio) by centre and date of transplantation. Immunosuppression-related events (IREs) included the occurrence of non-ventilator-associated pneumonia, tuberculosis, cytomegalovirus disease, and/or de novo malignancy.
Results: We identified 61 cases of late (>180 days after transplantation) IPA from 24 participating centres (accounting for 54.5% (61/112) of all cases included in the overall study). Most diagnoses (54.1% (33/61)) were established within the first 36 post-transplant months, although five cases occurred more than 10 years after transplantation. Overall mortality among cases was 47.5% (29/61). Compared with controls, cases were significantly older (p 0.010) and more likely to have pre-transplant chronic obstructive pulmonary disease (p 0.001) and a diagnosis of bloodstream infection (p 0.016) and IRE (p <0.001) within the 6 months prior to the onset of late IPA. After multivariate adjustment, previous occurrence of IRE (OR 19.26; 95% CI 2.07-179.46; p 0.009) was identified as an independent risk factor for late IPA.
Conclusion: More than half of IPA cases after KT occur beyond the sixth month, with some of them presenting very late. Late IPA entails a poor prognosis. We identified some risk factors that could help the clinician to delimit the subgroup of KT recipients at the highest risk for late IPA.
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http://dx.doi.org/10.1016/j.cmi.2017.06.016 | DOI Listing |
J Infect Dis
January 2025
Programa de Pós-graduação em Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.
There are insufficient predictors of progression to tuberculosis among contacts. A case-control study within RePORT-Brazil matched 20 QuantiFERON-positive progressors and 40 non-progressors by sex, age, and exposure duration. Twenty-nine cytokines were measured by Luminex in QuantiFERON-TB Gold Plus supernatants collected at baseline and evaluated using machine learning for tuberculosis prediction.
View Article and Find Full Text PDFJAMA Netw Open
November 2024
Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan.
Importance: The association between nonarteritic anterior ischemic optic neuropathy (NAION) and an increased risk of stroke has been a subject of debate. However, multinational studies on this topic are scarce.
Objective: To evaluate the short-term and long-term stroke risk after NAION compared with a matched control group.
Pharmacogenet Genomics
February 2025
Vanderbilt University Medical Center, Department of Medicine, Division of Infectious Diseases, Nashville, Tennessee, USA.
Background: Genetic polymorphisms have been associated with risk of antituberculosis treatment toxicity. We characterized associations with adverse events and treatment failure/recurrence among adults treated for tuberculosis in Brazil.
Methods: Participants were followed in Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil.
BMC Neurol
September 2024
Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Hasan Abad Sq., Tehran, Iran.
Background: Late-onset multiple sclerosis (LOMS), defined as the development of MS after the age of 50, has shown a substantial surge in incidence rates and is associated with more rapid progression of disability. Besides, studies have linked tobacco smoking to a higher chance of MS progression. However, the role of smoking on the risk of developing LOMS remains unclear.
View Article and Find Full Text PDFTransplantation
July 2024
Department of Infectious Diseases, Washington University School of Medicine, St. Louis, MO.
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