Good and impaired response to ganciclovir treatment of severe CMV infections in liver transplant recipients.
In this study we investigated good and impaired clinical responses to ganciclovir treatment of severe CMV disease in 23 adult liver transplant patients. CMV episodes were diagnosed by direct immunodetection of CMV-specific antigens in blood leukocytes and by viral cultures. The patients were monitored weekly for CMV antigenemia during the antiviral treatment. Sixteen out of 23 patients recovered from CMV episodes with the standard ganciclovir therapy of 2 weeks. Seven patients demonstrated an impaired response to ganciclovir and had to be treated for longer than 2 weeks (29 +/- 9 days). The patients with an impaired response to ganciclovir also demonstrated higher CMV antigenemia levels compared to those with good a response, and all still had antigenemia after 2 weeks' therapy. Thus, most severe CMV infections in liver transplant patients subsided with ganciclovir treatment of 2 weeks, but impaired responses also occurred and patients had to be treated for several weeks with ganciclovir before they recovered from CMV.
Transplantation Laboratory, University of Helsinki, Finland.
I
I
Lautenschlager
K
K
Höckerstedt
K
K
Salmela
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000627:therapeutic use*; D006801:Humans; D016031:Liver Transplantation; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D015774:Ganciclovir