title: Current characteristics and outcome of cytomegalovirus infections after kidney transplantation.
abstract: BACKGROUND
  The clinical course of cytomegalovirus (CMV) infections in the current era is poorly described. We characterized the symptoms and outcome of all CMV infections in a large cohort of kidney transplant recipients. Among 1129 kidney transplant recipients transplanted between 2004 and 2011 in Charité Universitätsmedizin Berlin and Helsinki University Hospital, 297 patients with CMV infection were characterized.
  
  
  RESULTS
  CMV disease occurred in 217/1129 patients (19.2%), and CMV infection in 297/1129 (26.3%). Gastrointestinal symptoms were recorded in 58% and fever in 47% patients with primary CMV disease, compared to 46% and 27% patients with symptomatic CMV reactivation, whereas leukopenia or thrombocytopenia were seen in only 17-28% patients, and malaise in 9-10%. Tissue-invasive CMV gastroenteritis was confirmed in 11% and CMV pneumonia in only 1% of patients with CMV disease. Only 1 patient died because of CMV infection (mortality 0.3%). Virus-related factors or the use of secondary prophylaxis did not predict the risk of recurrence, which occurred in 33% patients.
  
  
  CONCLUSIONS
  In conclusion, CMV disease remains a common problem after kidney transplantation. Gastrointestinal symptoms were common, especially in patients with primary CMV infection, whereas bone marrow suppression, hepatopathy, or malaise were seen less frequently.
authors: Department of Nephrology and Intensive Care, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany; Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany; Department of Medicine, Division of Nephrology, Helsinki University Central Hospital, Helsinki, Finland.
authors: I
authors: I
authors: Helanterä
authors: T
authors: T
authors: Schachtner
authors: C
authors: C
authors: Hinrichs
authors: K
authors: K
authors: Salmela
authors: L
authors: L
authors: Kyllönen
authors: P
authors: P
authors: Koskinen
authors: I
authors: I
authors: Lautenschlager
authors: P
authors: P
authors: Reinke
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001426:Bacterial Proteins; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D005858:Germany; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018832:Molecular Chaperones; D012189:Retrospective Studies; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D001426:Bacterial Proteins; D007166:Immunosuppressive Agents; D018832:Molecular Chaperones; C051582:virE1 protein, Agrobacterium tumefaciens; D000077562:Valganciclovir; D015774:Ganciclovir
keywords: CMV disease; cytomegalovirus; kidney transplantation; outcome