title: Surveillance of cytomegalovirus infection in haematopoietic stem cell transplantation patients.
abstract: OBJECTIVE
  The aim of this study was to describe our experience in the control of active CMV infection following HSCT using two strategies of CMV infection treatment: ganciclovir universal prophylaxis at low doses and pre-emptive therapy with ganciclovir.
  
  
  METHODS
  The surveillance was based on the monitoring of antigenaemia (AGM) and on a nested polymerase chain reaction (N-PCR) for the detection of CMV in both strategies. Forty-five recipients with malignant diseases and with a risk for CMV disease received universal prophylaxis (Group A). The non-treated group consisted of 24 patients, most of them with non-malignant diseases who did not receive universal prophylaxis (Group B).
  
  
  RESULTS
  In Group A, the incidence of positive AGM was 51%, with a positive PCR of 68.9%. In Group B, the AGM positivity was 66.7% and that of N-PCR was 66.7%. CMV disease occurred in 6/55 patients (10.9%), with 2/36 (5.5%) from Group A and 4/19 (21%) from Group B. Two of these six patients (33.3%) died of CMV disease.
  
  
  CONCLUSIONS
  Our result suggests that AGM and N-PCR can be used as markers for assessing the monitoring and the introduction pre-emptive therapy. This approach could prove to be more cost-effective than ganciclovir universal prophylaxis for treating CMV infection.
authors.affiliation: Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), CP 6111, CEP 13081-970, Campinas, São Paulo, Brazil.
authors.forename: Sandra H A
authors.initials: SH
authors.lastname: Bonon
authors.forename: Silvia M F
authors.initials: SM
authors.lastname: Menoni
authors.forename: Cláudio L
authors.initials: CL
authors.lastname: Rossi
authors.forename: Cármino A
authors.initials: CA
authors.lastname: De Souza
authors.forename: Afonso C
authors.initials: AC
authors.lastname: Vigorito
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Costa
authors.forename: Sandra C B
authors.initials: SC
authors.lastname: Costa
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010750:Phosphoproteins / Q000097:blood; D016133:Polymerase Chain Reaction; D011159:Population Surveillance; D014763:Viral Matrix Proteins / Q000097:blood
chemical_list: D000998:Antiviral Agents; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa; D015774:Ganciclovir