title: Cytomegalovirus (CMV) DNA load predicts relapsing CMV infection after solid organ transplantation.
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.
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA.
authors.forename: I G
authors.initials: IG
authors.lastname: Sia
authors.forename: J A
authors.initials: JA
authors.lastname: Wilson
authors.forename: C M
authors.initials: CM
authors.lastname: Groettum
authors.forename: M J
authors.initials: MJ
authors.lastname: Espy
authors.forename: T F
authors.initials: TF
authors.lastname: Smith
authors.forename: C V
authors.initials: CV
authors.lastname: Paya
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D003587:Cytomegalovirus / Q000302:isolation & purification / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000517:prevention & control* / Q000821:virology*; D004279:DNA, Viral / Q000097:blood; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D015774:Ganciclovir