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Diabetes Mellitus is a Risk Factor for Developing CMV Retinitis in Solid Organ Transplant Recipients: A Case-control Study

Title: Diabetes Mellitus is a Risk Factor for Developing CMV Retinitis in Solid Organ Transplant Recipients: A Case-control Study
Authors: Bharaj, Dilpreet K; Dhanji, Shanil; Gurung, Elena; Ladua, Gale; Lowe, Christopher F; Matic, Nancy; Gill, Justin; Mah, Allison; Wright, Alissa J; Ta Kim, David; Pakzad-Vaezi, Kaivon; Belga, Sara
Source: Open Forum Infectious Diseases ; volume 13, issue 2 ; ISSN 2328-8957
Publisher Information: Oxford University Press (OUP)
Publication Year: 2026
Description: Background The incidence of cytomegalovirus retinitis (CMVR) in solid organ transplant (SOT) recipients may be increasing due to improved long-term survival post-transplant. However, the epidemiology of CMVR after SOT is not well described. We therefore aimed to determine the incidence of CMVR and identify risk factors for its development post-SOT. Method Case-control study at a 1:4 ratio between January 1, 2012 and March 31, 2024. Cases were SOT recipients at 1 of 2 British Columbia transplant centres diagnosed with CMVR clinically or through ocular fluid viral PCR. Controls were matched on transplant organ, year, and center. Univariable and multivariable analyses were performed using conditional logistic regression models. Results Out of 5877 SOT recipients followed during the study period, there were 16 CMVR cases with an incidence rate of 5.3 per 10 000 person-years. Fourteen eligible cases of CMVR were matched to 56 controls. Cases were older than controls (median age 60.9 vs 42.6 years) and more likely to have diabetes mellitus (DM) (9 [64.3%] vs 9 [16.4%]), chronic heart disease (4 [28.6%] vs 4 [7.3%]), and CMV DNAemia any time post-SOT (12 [85.7%] vs 19 [35.2%]). Most received kidney transplants (50.0%), and the median time to CMVR was 3.4 years. After adjusting for age at transplant, DM, chronic heart disease, CMV DNAemia, and significant lymphopenia, only DM was associated with an increased odds of CMVR (odds ratio 16.5 [95% confidence interval, 1.12–243.8]). Conclusions CMVR is a rare and late complication post-SOT. DM was independently associated with increased odds of CMVR post-SOT.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/ofid/ofag056
DOI: 10.1093/ofid/ofag056/66799473/ofag056.pdf
Availability: https://doi.org/10.1093/ofid/ofag056; https://academic.oup.com/ofid/advance-article-pdf/doi/10.1093/ofid/ofag056/66799473/ofag056.pdf; https://academic.oup.com/ofid/article-pdf/13/2/ofag056/66799473/ofag056.pdf
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.306BCEF1
Database: BASE