TABLE 7.

Newer studies directly comparing preemptive therapy and prophylaxis for CMV prevention strategies in SOT recipients^a

Authors (reference)	Yr	SOT type	No. of patients		CMV serostatus	Monitoring strategy for PET	Drug regimen		PET vs prophylaxis					Follow-up duration (mos)	Other outcome(s)/conclusion(s)
			Total	PET vs prophylaxis			PET	Prophylaxis	% CMV infection	% CMV disease	% biopsy-proven allograft rejection	% mortality	% graft loss
Witzke et al. (137)	2018	KT	299	151 vs 148	R+	qPCR of plasma weekly for 1–4 wks, every 3 wks for 6–28 wks, on wk 40 and wk 52, and then twice a year	VGCV at 900 mg BID for >14 days	VGCV at 900 mg/day	39 vs 11	15 vs 5	13 vs 18	1 vs 2	5 vs 1	12	Rates of opportunistic infections were also similar between regimens, but higher rates of posttransplantation diabetes were observed with prophylaxis
Singh et al. (130)	2020	OLT		100 vs 105	D+ R−	qPCR of plasma weekly for 100 days	VGCV at 900 mg BID until 2 consecutive negative weekly tests	VGCV at 900 mg/day for 100 days	NR	9 vs 19	28 vs 25	15 vs 19	2 vs 2	12	Opportunistic infections and neutropenia were the same in both groups; PET significantly reduced the incidence of CMV disease compared to prophylaxis

^aClinical trials comparing PET and prophylaxis. NR, not reported; VGCV, valganciclovir; BID, twice a day.