title: Monitoring of human Cytomegalovirus infection by antigenemia and viremia in the first 100 days following renal transplantation and relation to antiviral strategies.
abstract: OBJECTIVE
  Human Cytomegalovirus (HCMV) is a relevant pathogen in transplant recipients, particularly in the first three months post-transplantation. The use of antiviral prophylaxis and pre-emptive therapy is able to reduce incidence of HCMV infection and disease. The incidence of HCMV infection and disease in renal transplant recipients in the first 100 days post-transplantation was investigated, in relation with HCMV serological matching and therapeutic management.
  
  
  METHODS
  Incidence of HCMV infection in the first 100 days post-transplantation was evaluated by pp65-antigenemia in 165 patients on a total number of 1241 clinical samples. Patients were divided in four groups according to donor/recipient serological matching: D(-)/R(-) (low risk of HCMV disease), D(-)/R+ and D+/R+ (intermediate risk) and D+/R(-) (high risk). Antiviral strategy (prophylaxis in high risk group; pre-emptive therapy in intermediate risk group, no therapy in low risk group) and immunosuppressive protocol were recorded.
  
  
  RESULTS
  Incidence of antigenemia-positivity was as follows: 0/3 D(-)/R(-) patients; 59/130 (45.4%) D+/R+; 5/16 (31.3%) D(-)/R+; 4/16 D+/R(-). No significative difference was found between the four groups in terms of incidence of antigenemia-positivity in the first 100 days following transplantation. Antigenemia values >50 pp65-positive/2x10(5) peripheral blood leukocytes (used to start pre-emptive therapy) were present in 18/130 (13.8%) D+/R+; 1/16 (6.2%) D+/R(-); 0/16 D(-)/R+. Viral kinetics in patients with HCMV infection was described.
  
  
  CONCLUSIONS
  No significative difference was found in terms of incidence of HCMV infection in the first 100 days post-transplantation in relation to immunosuppressive protocol and serological matching, suggesting the appropriateness of antiviral strategies and viral monitoring adopted in this setting.
authors.affiliation: Department of Public Health and Microbiology, Virology Unit, University of Turin, Turin, Italy.
authors.forename: M E
authors.initials: ME
authors.lastname: Terlizzi
authors.forename: C
authors.initials: C
authors.lastname: Costa
authors.forename: S
authors.initials: S
authors.lastname: Astegiano
authors.forename: F
authors.initials: F
authors.lastname: Sidoti
authors.forename: R
authors.initials: R
authors.lastname: Vendrame
authors.forename: G P
authors.initials: GP
authors.lastname: Segoloni
authors.forename: M
authors.initials: M
authors.lastname: Bergallo
authors.forename: R
authors.initials: R
authors.lastname: Cavallo
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010750:Phosphoproteins / Q000276:immunology*; D013997:Time Factors; D014763:Viral Matrix Proteins / Q000276:immunology*; D014766:Viremia / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D000998:Antiviral Agents; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa