Cytomegalovirus (CMV) DNA Load Predicts Relapsing CMV Infection After Solid Organ Transplantation

J Infect Dis. 2000 Feb;181(2):717-20. doi: 10.1086/315242.

Abstract

Cytomegalovirus (CMV) DNA load was analyzed as a marker for relapse of CMV infection in 24 solid organ transplant patients with CMV infection or disease who received a fixed 14-day course of intravenous ganciclovir. Viral load was measured in blood samples obtained before and at the completion of treatment. Eight (33%) of 24 patients developed relapsing CMV infection. Median pretreatment viral loads were higher in the relapsing group (80,150 copies/106 leukocytes) than in the nonrelapsing group (5500 copies/106 leukocytes; P=.007). The relapsing group also had persistent detectable viral DNA (median, 5810 copies/106 leukocytes) after treatment, whereas it was undetectable in the nonrelapsing group (P<. 0001). Primary CMV infection (seronegative recipients of seropositive organs, D+R-) was an independent marker for CMV relapse (P=.03), and these patients had higher pre- and posttreatment viral loads than did non-D+/R- patients (P<.0001 and P=.0014, respectively). CMV DNA load is a useful marker for individualizing antiviral treatment of CMV infection in solid organ transplant recipients.

MeSH terms

  • Adolescent
  • Adult
  • Antiviral Agents / therapeutic use
  • Child
  • Cytomegalovirus / isolation & purification
  • Cytomegalovirus / physiology*
  • Cytomegalovirus Infections / prevention & control*
  • Cytomegalovirus Infections / virology*
  • DNA, Viral / blood
  • Ganciclovir / therapeutic use
  • Humans
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • Prospective Studies
  • Recurrence
  • Viral Load*

Substances

  • Antiviral Agents
  • DNA, Viral
  • Ganciclovir