title: Clinical usefulness of human cytomegalovirus antigenemia assay after kidney transplantation.
abstract: BACKGROUND
  Human (H) cytomegalovirus (CMV) infections are a major cause of morbidity and mortality among kidney transplants. We performed a prospective study to evaluate the clinical usefulness of HCMV antigenemia assay for preemptive treatment after kidney transplantation.
  
  
  METHODS
  A total of 100 patients were followed up by HCMV antigenemia assay at posttransplantation weeks 1, 3, 5, 7, 9, 13, 17, and 21. Asymptomatic patients with positive antigenemia were observed without specific antiviral therapy.
  
  
  RESULTS
  Most patients had been given cyclosporine A- and prednisolone-based immunosuppressive therapy (99.0%) and were HCMV seropositive before transplantation (99.0%). A positive antigenemia assay was detected in 41 patients among 97 eligible patients. Symptomatic CMV diseases were observed in 10 of 41 patients. HCMV infections were related to history of acute rejection and use of antithymocyte globulin. HCMV-related symptoms and signs were clearly correlated with the level of antigenemia. All patients who had an HCMV antigenemia titer of higher than 50 per 400,000 leukocytes developed HCMV-related symptoms and signs during the follow-up period. This criterion showed the highest positive predictive value and specificity in the development of symptomatic HCMV infection.
  
  
  CONCLUSIONS
  Data suggest that HCMV antigenemia titer can be used as a useful guide to preemptive treatment of HCMV infection after kidney transplantation in HCMV-positive donor and recipient.
authors.affiliation: Department of Internal Medicine, Seoul Veterans Hospital, Seoul, Korea.
authors.forename: Choon Kwan
authors.initials: CK
authors.lastname: Kim
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
authors.forename: Sung-min
authors.initials: SM
authors.lastname: Kim
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Wonsup
authors.initials: W
authors.lastname: Oh
authors.forename: Wooseong
authors.initials: W
authors.lastname: Huh
authors.forename: Yoon-Goo
authors.initials: YG
authors.lastname: Kim
authors.forename: Sung Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Joh
authors.forename: Nam Yong
authors.initials: NY
authors.lastname: Lee
authors.forename: Chung-Gyu
authors.initials: CG
authors.lastname: Park
authors.forename: Eung-Soo
authors.initials: ES
authors.lastname: Hwang
authors.forename: Chang-Yong
authors.initials: CY
authors.lastname: Cha
authors.forename: Ha-Young
authors.initials: HY
authors.lastname: Oh
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000097:blood*; D001772:Blood Cell Count; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology; D006650:Histocompatibility Testing; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology*; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D000956:Antigens, Viral; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D016572:Cyclosporine