title: Late-onset CMV disease following CMV prophylaxis.
abstract: BACKGROUND
  Cytomegalovirus (CMV) is the most common opportunistic infection after solid-organ transplantation, increasing morbidity and mortality. Three months of oral valganciclovir have been shown to provide effective prophylaxis. Late-onset CMV disease, occurring after the discontinuation of prophylaxis, is now increasingly recognised.
  
  
  OBJECTIVE
  To investigate the incidence and the time of detection of CMV infections in liver transplant recipients who received CMV prophylaxis.
  
  
  METHODS
  Retrospective review of 64 high- and moderate-risk patients with 1 year of follow-up.
  
  
  RESULTS
  The incidence of CMV infection was 12.5%, with 4.7% disease. All cases of symptomatic CMV disease were of late-onset.
  
  
  CONCLUSIONS
  The incidence of CMV infections in this study was low compared with literature reports; however, the late-onset disease is an emerging problem. Detection of late-onset disease may be delayed because of less frequent clinic follow-up visits. Increased regular laboratory monitoring may allow earlier detection at the asymptomatic infection stage.
authors.affiliation: Pharmacy Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. c.donnelly@st-vincents.ie
authors.forename: C
authors.initials: C
authors.lastname: Donnelly
authors.forename: F
authors.initials: F
authors.lastname: Kennedy
authors.forename: C
authors.initials: C
authors.lastname: Keane
authors.forename: K
authors.initials: K
authors.lastname: Schaffer
authors.forename: P A
authors.initials: PA
authors.lastname: McCormick