Clinical course of cytomegalovirus (CMV) viremia with and without ganciclovir treatment in CMV-seropositive kidney transplant recipients. Longitudinal follow-up of CMV pp65 antigenemia assay.

Abstract

This study was designed to evaluate the longitudinal history of cytomegalovirus (CMV) infection and to test the capacity of ganciclovir as effective therapy in CMV-seropositive renal transplant recipients. The CMV viremia was detected with CMV pp65 antigenemia assay in 153 renal transplants. The recipients were classified as having low-grade and high-grade CMV infections according to the severity of CMV infection. The recipients with low-grade CMV infections were observed without ganciclovir treatment, and the recipients with high-grade CMV infection were randomly assigned to ganciclovir-treated and untreated groups. The clinical course between low-grade and high-grade CMV infections was evaluated. All recipients with low-grade CMV infection (n = 62) showed spontaneous remission regardless of immunosuppresants. In high-grade CMV infection (n = 31), the ciclosporin A treated group (n = 11) showed no evidence of CMV disease, and the methylprednisolone-treated group (n = 8) showed CMV disease in 1 (25%) of 4 ganciclovir-untreated recipients. In the OKT3 group (n = 12), symptomatic CMV infection was observed in 6 (100%) ganciclovir-untreated recipients contrary to no CMV disease in the ganciclovir-treated group (p < 0.05). In conclusion, the CMV antigenemia assay is effective in monitoring CMV viremia, and ganciclovir treatment should be done during early CMV viremia in OKT3-treated recipients.

• Authors: C W Yang, Y O Kim, Y S Kim, S Y Kim, I S Moon, H J Ahn, Y B Koh, B K Bang
• Journal: American journal of nephrology (Am J Nephrol) Vol. 18 Issue 5 Pg. 373-8 ( 1998) ISSN: 0250-8095 [Print] Switzerland
• PMID: 9730559 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Viral
• Antiviral Agents
• Immunosuppressive Agents
• Phosphoproteins
• Ganciclovir

Topics

• Adult
• Aged
• Antibodies, Viral (blood)
• Antiviral Agents (therapeutic use)
• Cytomegalovirus (immunology)
• Cytomegalovirus Infections (diagnosis, drug therapy)
• Female
• Follow-Up Studies
• Ganciclovir (therapeutic use)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Kidney Transplantation
• Male
• Middle Aged
• Phosphoproteins (blood)
• Prospective Studies
• Viremia (diagnosis, drug therapy)