Methods: Patients who received an allo-HCT between January 2009 and September 2013 were identified from the Premier Hospital database using ICD-9-CM codes. The first allo-HCT procedure was defined as the index event. The frequencies of opportunistic infections, documented by diagnostic codes, were evaluated during the index hospitalization and 12 months after the index allo-HCT hospitalization.
Results: Of patients who received allo-HCT (n=1,617; mean age: 42.5 years) 57% were male and 18% were ≤18 years of age. Most patients received allo-HCT in urban (94%), large (≥600 beds: 72%), teaching hospitals (96%). During the index hospitalization, 851 patients (53%) had a diagnostic code for ≥1 opportunistic infection in their discharge records, and 13% (n=216) had dsDNA viral infections. Among patients with dsDNA viral infections, 51% (n=110) had infections of cytomegalovirus (CMV), 14% (n=30) BK virus, 6% (n=13) adenovirus (AdV), and 38% (n=82) had other dsDNA viral infections (VZV, Herpes, HPV, EBV). Among the patients who survived the index allo-HCT hospitalization (n=1,499), 46% (n=683) had a diagnostic code for ≥1 opportunistic infection and 18% (n=273) had dsDNA viral infections. Among patients with dsDNA viral infections, 73% (n=198) had infections with CMV, 16% (n=45) BK virus, 5% (n=15) AdV, and 27% (n=74) had other dsDNA viral infections.
Conclusion: Based on analysis of hospital discharge records, about three out of every four allo-HCT recipients in this study population had an opportunistic infection during the first year post allo-HCT, this estimate is conservative due to potential undercoding. One out of every 3 opportunistic infections was a dsDNA viral infection. Although antimicrobials are initiated post allo-HCT to prevent opportunistic bacterial and fungal infections, the toxicities of current antiviral drugs do not allow their use for routine prevention of viral infections among these severely immunocompromised patients.
Novosys Health: Employee , Salary
M. Lingohr-Smith, Novosys Health: Employee , Salary
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