Female sex and advanced age are associated with invasive cytomegalovirus disease in solid organ transplant recipients

Whitney A. Perry, Bradley J. Gardiner, Lori Lyn Price, Marta Rodriguez-Garcia, Jennifer K. Chow, David R. Snydman

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)


Background: Limited data exist to describe sex-based differences in the severity of cytomegalovirus (CMV) infection after solid organ transplant (SOT). We sought to identify if a difference exists in likelihood of tissue-invasive disease between male and female SOT recipients and to understand how age affects this relationship. Methods: A retrospective cohort of 180 heart, liver, and kidney recipients treated for CMV was examined. A logistic regression model was developed to assess the relationship between female sex and CMV type (noninvasive vs. invasive). A secondary regression analysis looked at the relationship of invasive CMV with a variable combining sex with age above or below 50. Results: There were 37 cases of proven or probable invasive CMV, occurring in 30% of females versus 16% of males. After adjustment for potential confounders, females with CMV infection were significantly more likely to have invasive disease (odds ratio (OR) 2.69, 95% confidence interval (CI) 1.25–5.90, p =.01). Females 50 years or older were at particular risk compared with males under 50 years (adjusted OR 4.54, 95% CI 1.33–18.83, p =.02). Conclusion: Female SOT recipients with CMV in our cohort were more likely than males to have tissue-invasive disease, with the highest risk among older females. Further prospective studies are warranted to explore underlying immunologic mechanisms. (Figure presented.).

Original languageEnglish
Article numbere13960
Number of pages8
JournalTransplant Infectious Disease
Issue number6
Publication statusPublished - Dec 2022


  • cytomegalovirus
  • female
  • sex-differences
  • solid organ transplant

Cite this