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Minerva Medica 2008 June;99(3):231-9

language: English, Italian

Monitoring of human Cytomegalovirus infection by antigenemia and viremia in the first 100 days following renal transplantation and relation to antiviral strategies

Terlizzi M. E. 1, Costa C. 1, Astegiano S. 1, Sidoti F. 1, Vendrame R. 1, Segoloni G. P. 2, Bergallo M. 1, Cavallo R. 1

1 Department of Public Health and Microbiology Virology Unit, University of Turin, Turin, Italy
2 Renal Transplant Unit Department of Internal Medicine, University of Turin, Turin, Italy


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Aim. Human Cytomegalovirus (HCMV) is a relevant pathogen in transplant recipients, particularly in the first three months post-transplantation. The use of antiviral prophylaxis and pre-emptive therapy is able to reduce incidence of HCMV infection and disease. The incidence of HCMV infection and disease in renal transplant recipients in the first 100 days post-transplantation was investigated, in relation with HCMV serological matching and therapeutic management.
Methods. Incidence of HCMV infection in the first 100 days post-transplantation was evaluated by pp65-antigenemia in 165 patients on a total number of 1 241 clinical samples. Patients were divided in four groups according to donor/recipient serological matching: D–/R– (low risk of HCMV disease), D–/R+ and D+/R+ (intermediate risk) and D+/R– (high risk). Antiviral strategy (prophylaxis in high risk group; pre-emptive therapy in intermediate risk group, no therapy in low risk group) and immunosuppressive protocol were recorded.
Results. Incidence of antigenemia-positivity was as follows: 0/3 D–/R– patients; 59/130 (45.4%) D+/R+; 5/16 (31.3%) D–/R+; 4/16 D+/R–. No significative difference was found between the four groups in terms of incidence of antigenemia-positivity in the first 100 days following transplantation. Antigenemia values >50 pp65-positive/2¥105 peripheral blood leukocytes (used to start pre-emptive therapy) were present in 18/130 (13.8%) D+/R+; 1/16 (6.2%) D+/R–; 0/16 D–/R+. Viral kinetics in patients with HCMV infection was described.
Conclusion. No significative difference was found in terms of incidence of HCMV infection in the first 100 days post-transplantation in relation to immunosuppressive protocol and serological matching, suggesting the appropriateness of antiviral strategies and viral monitoring adopted in this setting.

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