Optimizing prevention of cytomegalovirus infection using individualized dosing of valganciclovir immunosuppressed patients

Immunosuppressed patients such as transplant recipients are at high risk for infections that don’t normally affect healthy individuals. Cytomegalovirus (CMV) is one of the most common and significant of these – it causes clinical disease and leads to other poor outcomes. Valganciclovir is a highly effective antiviral drug that can both treat and prevent CMV infection. However dosing valganciclovir can be complex, particularly in the setting of patients with reduced kidney function, with a risk of side effect including neutropenia limiting its use. Monitoring the levels of valganciclovir in the blood is a newly available method that offers the promise of optimized, individualized dosing that could reduce the risk of side effects while maintaining efficacy of this key antiviral agent. This clinical research project aims to understand the benefits and role of measuring ganciclovir levels in optimizing valganciclovir dosing. It will be based on existing retrospective cohort of patients, with additional clinical data collection to be needed from electronic medical records. It will involve statistical analyses and other clinical research methodologies but no laboratory work. Previous experience using R is desirable but not essential. It will set the groundwork for future clinical trials of different preventative strategies. It will be based within the Department of Infectious Diseases and co-supervised by Dr Bradley Gardiner & Dr Rekha Pai Mangalore.