Khadijeh Delroba’s research while affiliated with Tehran University of Medical Sciences and other places

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Publications (3)


PRISMA diagram showing study selection process. Legend: The flowchart shows the number of studies that were found, reviewed, and excluded, and the reasons for exclusion at each step of the process
Traffic light plot for risk of bias assessment using the ROBINS-I tool for non-randomized studies. Legend: ROBINS-I tool for the assessment of risk of bias in non-randomized studies presented in the form of a traffic light plot. Studies are presented with color-coded assessments indicating their risk levels, allowing for easy visualization of their internal validity
Traffic light plot for risk of bias assessment using ROB 2.0 for randomized controlled studies. Legend: Traffic light plot for risk of bias assessment using the ROB 2.0 tool for randomized controlled trials. Studies are presented with color-coded assessments indicating their risk levels, allowing for easy visualization of their internal validity
Funnel plot illustrating the effect of antiviral prophylaxis on the incidence of PTLD (left) and EBV viremia (right). Legend: The funnel plot of the log risk ratio against the standard error for antiviral prophylaxis on the incidence of PTLD (left) and EBV viremia (right). The asymmetry of the plots observed indicates the possibility of publication bias
Effect of antiviral prophylaxis on the incidence of EBV viremia. Legend: Forest plot showing the impact of antiviral prophylaxis on the occurrence of EBV viremia. The plot summarizes effect estimates and confidence intervals, demonstrating the protective effect of prophylaxis

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Impact of antiviral prophylaxis on EBV viremia and posttransplant lymphoproliferative disorders in solid organ transplant recipients: a systematic review and meta-analysis
  • Literature Review
  • Full-text available

January 2025

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6 Reads

Virology Journal

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Khadijeh Delroba

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[...]

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Introduction Organ transplant recipients face a substantial risk of developing posttransplant lymphoproliferative disorders (PTLD). In over 90% of cases with B‐cell PTLD following solid organ transplantation, the Epstein‐Barr virus (EBV) genome is promptly identified, usually within the initial year. A continuing discussion revolves around the efficacy of antiviral prophylaxis in mitigating the incidence of PTLD in solid organ transplant (SOT) patients. This study aimed to conduct a systematic review and meta-analysis to investigate this issue. Method A comprehensive search was conducted up to December 31, 2023, in databases including PubMed, Embase, and the Cochrane Library for retrospective and prospective studies comparing antiviral prophylaxis effects on EVB viremia and PTLD incidence in SOT recipients. Fixed or random effect models were applied based on the heterogeneity assessed via the I² statistic, using Stata 16.0 software for data analysis. Results In total, 22 eligible studies involving 13,498 patients were analyzed. Antiviral prophylaxis was associated with a significant reduction in EBV viremia incidence in SOT recipients, as demonstrated in 10 studies (relative risk (RR) 0.69, 95% CI 0.54 to 0.88). The rate of PTLD was significantly lower among those who received antiviral prophylaxis compared to those who did not, as reported in 18 studies (RR 0.77, 95% CI 0.63 to 0.94). No significant difference was observed in the subgroup of high-risk recipients based on EBV serology (RR 1.13, 95% CI 0.72 to 1.78). Additionally, a notable reduction in PTLD incidence was seen in the pediatric subgroup (RR 0.58, 95% CI 0.43 to 0.79) using antiviral prophylaxis, while no significant differences were observed in the subgroup of adults (RR 0.88, 95% CI 0.64 to 1.21). Administration of antiviral prophylaxis can significantly reduce the incidence of PTLD among kidney (RR 0.63, 95% CI 0.46 to 0.87) and heart transplant patients (RR 0.61, 95% CI 0.39 to 0.96). PTLD incidence was significantly reduced among recipients of T-cell depletion or steroid-based immunosuppression using antiviral prophylaxis (RR 0.54, 95% CI 0.39–0.74 and RR 0.55, 95% CI 0.41–0.73, respectively). Conclusion This meta-analysis revealed that administering antiviral prophylaxis to patients after solid organ transplantation reduces PTLD and EBV viremia occurrences, especially among pediatric recipients, individuals undergoing kidney or heart transplantation, and those receiving high-intensity immunosuppression regimens. Key Summary Points Post-transplant lymphoproliferative disorders (PTLD) and other EBV syndromes are among the most serious complications following solid organ transplantation (SOT), primarily due to the necessity for prolonged immunosuppressive therapy. Among the strategies for preventing EBV-related complications, the use of antiviral prophylaxis is a subject of ongoing debate. This systematic review and meta-analysis found that antiviral prophylaxis significantly reduced EBV viremia incidence (risk ratio (RR) 0.69, 95% confidence interval (CI) 0.54 to 0.88) compared to those without prophylaxis. In the sub-analysis related to high-risk EBV serologically mismatched SOT recipients (EBV D+/R-), the result did not show a significant difference in terms of PTLD incidence (RR 1.13, 95% CI 0.72 to 1.78). Antiviral prophylaxis significantly impacted the occurrence of PTLD events among pediatric SOT patients (RR 0.58, 95% CI 0.43 to 0.79), but not among adult patients (RR 0.88, 95% CI 0.64 to 1.21). Antiviral prophylaxis significantly impacted the occurrence of PTLD events among kidney/simultaneous pancreas and kidney (RR 0.63, 95% CI 0.46 to 0.87) and heart (RR 0.61, 95% CI 0.39 to 0.96) transplant patients but not liver (RR 0.5, 95% CI 0.23 to 1.08) transplant recipients.

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Treatment Options for Infections Caused by Multidrug-Resistant Gram-Negative Bacteria: A Guide To Good Clinical Practice

May 2023

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78 Reads

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2 Citations

The rapid emergence of multidrug-resistant Gram-negative bacterial infections necessitates the development of new treatments or the repurposing of available antibiotics. Here, treatment options for treatment of these infections, recent guidelines and evidence are reviewed. Studies that included treatment options for infections caused by multidrug-resistant Gram-negative bacteria (Enterobacterales and nonfermenters), as well as extended-spectrum β-lactamase-producing and carbapenem-resistant bacteria, were considered. Potential agents for the treatment of these infections, considering type of microorganism, mechanism of resistant, source and severity of infection as well as pharmacotherapy considerations, are summarized.

Citations (1)


... infectious, and other diseases [1][2][3][4][5][6][7][8][9]. Similarly, drug repurposing is very important for many categories of patients with orphan diseases, particularly the millions of patients in developing countries, where health resources are scarce [10][11][12]. ...

Reference:

The Vital Role Played by Deferiprone in the Transition of Thalassaemia from a Fatal to a Chronic Disease and Challenges in Its Repurposing for Use in Non-Iron-Loaded Diseases
Treatment Options for Infections Caused by Multidrug-Resistant Gram-Negative Bacteria: A Guide To Good Clinical Practice
  • Citing Article
  • May 2023