2095. Associations between Invasive Aspergillosis and Cytomegalovirus Infections in Lung Transplant Recipients

Abstract Background Cytomegalovirus infection (CMV) and invasive aspergillosis (IA) are important causes of morbidity mortality among lung transplant recipients (LTXr). These opportunistic infections share risk factors, but their interrelationship need further evaluation. Early diagnosis treatment may improve outcomes. We examined incidence rates CMV after IA vice versa to assess whether screening for one these be indicated when the other is diagnosed. Methods All adults receiving a in Denmark from 2010 2019 were included followed 2 years transplantation. was defined using ISHLT criteria. Standardized performed during study period (Figure 1). Incidence (IR) rate ratios (IRR) estimated by multivariate Poisson regression adjusted time transplantation (time updated), sex, age high-risk serostatus/IA condition. In analyses CMV, we as updated variable, IA, variable. Figure 1Screening protocol cytomegalovirus following Valganciclovir prophylaxis administered patients with serostatus D+/R−, D+/R+, D−/R+ three months 2010-2016 voriconazole antifungal all LTXr 2016-2019 posaconazole inhaled amphotericin B at high IA. D, Donor; R, Recipient; PCR, Polymerase Chain Reaction; cytomegalovirus; BAL, bronchoalveolar lavage; Lung biopsy, transbronchial biopsy Results A total 295 351 person-years follow-up (PYFU) 440 PYFU (Table diagnosed 122 (41.4%) 57 (19.3%) LTXr, respectively 2). proven 20 probable 37 Among 15.8% developed within 3 months, IR 109 per 100 (95% CI 57-210) The median viral load 2900 copies/mL (IQR 525-19000). first there an increased although not statistically significant adjustment LTX aIRR 1.60 0.80-3.20). 8.2% 40 22-75) diagnosis, significantly 2.97 1.47-6.00). Numbers needed screen diagnose case approximately 6 12, respectively. Table 1:Characteristics recipient infectious outcomes, n (%)*IA conditions; **Number negative blood samples positive BAL (minimum >3000 copies/mL). Invasive criteria including anastomosis infection, tracheobronchitis pneumonia.TX, Transplantation; COPD, Chronic obstructive pulmonary disease; Bronchoalveolar lavage.Table 2:Incidence (IA)1Adjusted >50 years, serostatus. 2Adjusted transplantation, 3Adjusted underlying 4Adjusted condition.CMV, IR, rate; PYFU, Person-years follow-up; IRR, ratios; aIRR, ratio; CI, confidence interval; TX, transplantation; aspergillosis.Figure 2:Kaplan-Meier survival estimates (A) (B) Conclusion Systematic versa, timeliness thereby outcomes recipients. Disclosures Maiken C. Arendrup, DMSci, PhD, MD, Chiesi, Gilead: Honoraria|F2G, Cidara, Scynexis: Grant/Research Support Marie Helleberg, DMSc, AstraZeneca: Advisor/Consultant|Gilead: Honoraria|GSK: Advisor/Consultant|GSK: Honoraria|Janssen: Advisor/Consultant|Roche: Advisor/Consultant|Sobi: Advisor/Consultant.