Sophida Boonsathorn (Thailand)

Faculty of Medicine Ramathibohi Hospital Department of Pediatrics
Dr. Sophida Boonsathorn is an assistant professor of medicine at the faculty of medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. She has served as a lecturer in the Division of Infectious Diseases since 2014. Dr. Boonsathorn graduated from the Faculty of Medicine Siriraj Hospital, Mahidol University. She was a clinical fellow of infectious diseases at the Faculty of Medicine Ramathibodi Hospital, Mahidol University. She obtained her Master of Sciences in Infection and Immunity and Master of Research in Child Health from University College London, UK. Dr. Boonsathorn’s research is focusing on general infectious diseases, infection in transplant recipients, and antimicrobial stewardship.

Author Of 1 Presentation

 Conference Calendar

RISK FACTORS OF CYTOMEGALOVIRUS INFECTION AFTER PEDIATRIC LIVER TRANSPLANTATION AND EFFECTIVENESS OF PREEMPTIVE THERAPY

Date
Wed, 11.05.2022
Session Time
13:40 - 15:10
Session Type
Parallel Symposium
Session Name
0390 - PARALLEL SYMPOSIUM: Infections in Immunocompromised Hosts (ID 58)
Room
MC 2 HALL
Presenter
Lecture Time
14:47 - 14:57

Abstract

Backgrounds:

Cytomegalovirus (CMV) infection is the most common viral infection after liver transplantation (LT). Preemptive therapy (PET) is an alternate approach in which antiviral therapy is initiated for early asymptomatic CMV viremia. However, the optimal viral load (VL) cut-off for initiating PET remains controversial. Therfore, this study aimed to evaluate the incidence of CMV infection, risk factors, and outcomes of PET after using different VL cut-offs in pediatric LT.

Methods

We retrospectively reviewed 126 patients aged 0-18 years who underwent LT between March 2011 and August 2020. CMV viremia was regularly monitored using quantitative nucleic acid amplification in all patients. Data on clinical characteristics and potential risk factors, including CMV serostatus, acute cellular rejection (ACR), and immunosuppressive drugs were collected. CMV infection and diseases were defined according to International guidelines. Additionally, clinical outcomes for starting PET at low VL cut-off (< 2000 copies/mL) and high VL cut-off (≥ 2000 copies/mL) were compared.

Results:

In total, 90 of 126 patients (71%) developed CMV infection with a median onset of 30.2 days (Interquartile range (IQR) 13, 39). In a univariate analysis, factors associated with CMV infection included younger age, CMV D+/R-, ACR, and higher corticosteroid dosage. Only corticosteroid dosage remained associated with CMV infection in a multivariate analysis [adjusted odds ratio (OR) 116.9; 95% confidence interval (CI) 17.75-770.98; p<0.001]. Recurrent CMV infection, CMV diseases, ACR, and Epstein-Barr Virus infection did not differ significantly between the low and the high VL cut-off groups.

Conclusions/Learning Points:

The incidence of CMV infection was high in pediatric LT. Higher corticosteroid dosage was associated with CMV infection. Additionally, using CMV VL cut-off at 2000 copies/mL for initiating antiviral therapy seems to be a practical and effective strategy to prevent CMV diseases.

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Presenter of 1 Presentation

 Conference Calendar

RISK FACTORS OF CYTOMEGALOVIRUS INFECTION AFTER PEDIATRIC LIVER TRANSPLANTATION AND EFFECTIVENESS OF PREEMPTIVE THERAPY

Date
Wed, 11.05.2022
Session Time
13:40 - 15:10
Session Type
Parallel Symposium
Session Name
0390 - PARALLEL SYMPOSIUM: Infections in Immunocompromised Hosts (ID 58)
Room
MC 2 HALL
Presenter
Lecture Time
14:47 - 14:57

Abstract

Backgrounds:

Cytomegalovirus (CMV) infection is the most common viral infection after liver transplantation (LT). Preemptive therapy (PET) is an alternate approach in which antiviral therapy is initiated for early asymptomatic CMV viremia. However, the optimal viral load (VL) cut-off for initiating PET remains controversial. Therfore, this study aimed to evaluate the incidence of CMV infection, risk factors, and outcomes of PET after using different VL cut-offs in pediatric LT.

Methods

We retrospectively reviewed 126 patients aged 0-18 years who underwent LT between March 2011 and August 2020. CMV viremia was regularly monitored using quantitative nucleic acid amplification in all patients. Data on clinical characteristics and potential risk factors, including CMV serostatus, acute cellular rejection (ACR), and immunosuppressive drugs were collected. CMV infection and diseases were defined according to International guidelines. Additionally, clinical outcomes for starting PET at low VL cut-off (< 2000 copies/mL) and high VL cut-off (≥ 2000 copies/mL) were compared.

Results:

In total, 90 of 126 patients (71%) developed CMV infection with a median onset of 30.2 days (Interquartile range (IQR) 13, 39). In a univariate analysis, factors associated with CMV infection included younger age, CMV D+/R-, ACR, and higher corticosteroid dosage. Only corticosteroid dosage remained associated with CMV infection in a multivariate analysis [adjusted odds ratio (OR) 116.9; 95% confidence interval (CI) 17.75-770.98; p<0.001]. Recurrent CMV infection, CMV diseases, ACR, and Epstein-Barr Virus infection did not differ significantly between the low and the high VL cut-off groups.

Conclusions/Learning Points:

The incidence of CMV infection was high in pediatric LT. Higher corticosteroid dosage was associated with CMV infection. Additionally, using CMV VL cut-off at 2000 copies/mL for initiating antiviral therapy seems to be a practical and effective strategy to prevent CMV diseases.

Hide