title: A short-term preemptive treatment for cytomegalovirus infection in seropositive patients after liver transplantation.
abstract: OBJECTIVE
  Cytomegalovirus (CMV) infection remains a challenge following liver transplantation. Preemptive treatment is an effective strategy for CMV infection. However, how long preemptive treatment should be applied is not defined.
  
  
  METHODS
  Clinical records of preemptive treatment for CMV infection in patients who underwent liver transplantation were collected. CMV antigenemia (pp65) was monitored weekly during hospital stay and subsequently on follow up whenever indicated clinically. Antiviral treatment was administered based on positive antigenemia (>1 positive cell per 500,000 leukocytes) and discontinued when antigenemia became negative.
  
  
  RESULTS
  CMV infection was diagnosed in 58 (43.9%) of 132 liver transplantation patients. All 58 patients were seropositive for CMV before transplantation. CMV infection was first diagnosed at a median time of 20 days (interquartile range [IQR] 15.3-26) after transplantation. Twelve (20.7%) patients developed repeated infections. Only one of 58 patients (1.7%) was suspected to have invasive disease. The median (IQR) duration of antiviral treatment was 7 (7-12) days. Of these patients with CMV infection, 14 (24.1%) patients developed acute rejection peri-anti-CMV treatment and 36 (62.1%) developed other infectious complications.
  
  
  CONCLUSIONS
  Preemptive treatment is an effective way to halt the progression of asymptomatic CMV infection. A brief course of antiviral treatment is enough for seropositive patients with CMV infection after liver transplantation.
authors.affiliation: Department of Liver and Transplantation Surgery, Chang-Gung Transplantation Institute, Chang-Gung Memorial Hospital, Chang-Gung University Medical School, Taoyuan, Taiwan.
authors.forename: Divya
authors.initials: D
authors.lastname: Dahiya
authors.forename: Chen-Fang
authors.initials: CF
authors.lastname: Lee
authors.forename: Kun-Ming
authors.initials: KM
authors.lastname: Chan
authors.forename: Ting-Jung
authors.initials: TJ
authors.lastname: Wu
authors.forename: Hong-Shiue
authors.initials: HS
authors.lastname: Chou
authors.forename: Shin-Shin
authors.initials: SS
authors.lastname: Cheng
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage / Q000627:therapeutic use*; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007166:Immunosuppressive Agents; D015774:Ganciclovir