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- Title
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.
- Authors
Yang, Chul Woo; Kim, Young Ok; Kim, Yong Soo; Kim, Suk Young; Moon, In Sung; Ahn, Hee Jong; Koh, Yong Bok; Bang, Byung Kee; Yang, C W; Kim, Y O; Kim, Y S; Kim, S Y; Moon, I S; Ahn, H J; Koh, Y B; Bang, B K
- 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.
- Subjects
CYTOMEGALOVIRUS disease diagnosis; GANCICLOVIR; ANTIVIRAL agents; IMMUNOSUPPRESSIVE agents; COMPARATIVE studies; CYTOMEGALOVIRUS diseases; CYTOMEGALOVIRUSES; KIDNEY transplantation; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; PHOSPHOPROTEINS; RESEARCH; STATISTICAL sampling; VIRAL antibodies; EVALUATION research; RANDOMIZED controlled trials; VIREMIA; DIAGNOSIS; THERAPEUTICS
- Publication
American Journal of Nephrology, 1998, Vol 18, Issue 5, p373
- ISSN
0250-8095
- Publication type
journal article
- DOI
10.1159/000013379