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Introduction: In immunocompetent individuals, past CMV infection has been linked to venous thromboembolism (VTE) risk, but evidence remains inconclusive due to timing of serologic diagnosis. Data in immunocompromised patients are scarce. We therefore assessed VTE risk following CMV viremia in kidney transplant recipients (KTRs). Methods: We conducted a multicenter cohort study of 15, 433 KTRs transplanted between 2000 and 2021, among whom 1, 756 developed CMV infection, with a 2-year cumulative incidence of 13% (95% CI: 12.4-13.5%). VTE occurred in 6.7% of KTRs (95% CI: 6.3-7.1%). Results: Using time-varying Cox models stratified on centers and transplant period, asymptomatic CMV viremia (considered as a time-dependent parameter) was significantly associated with an increased VTE risk (HR = 1.61, 95% CI: 1.19-2.17), with a higher risk after symptomatic CMV disease (HR = 2.00, 95% CI: 1.32-3.02), after adjustment for confounders. The risk was similar following primary infection or a reactivation of latent CMV. Conclusion: In conclusion, CMV viremia, especially symptomatic disease, was associated to a higher risk of VTE in KTRs. Given the frequency of CMV post-transplant, clinicians should be aware of this association for prompt diagnosis and management.
Masset et al. (Fri,) studied this question.