title: Clinical Utility of Viral Load in the Management of Cytomegalovirus Infection in Solid Organ Transplant Patients in Kuwait.
abstract: BACKGROUND
  Infection with human cytomegalovirus (CMV) in solid organ transplant patients remains an unresolved challenge, despite improvements in immunosuppressive therapy, post-transplantation care, viral prevention, and therapy.
  
  
  METHODS
  We conducted quantitative real-time polymerase chain reaction (PCR) assays of CMV on plasma samples of 1,168 patients in Kuwait who received solid organ transplants from 2012 to 2014 to detect and monitor CMV DNA viral load.
  
  
  RESULTS
  Of the 1,168 patients, 180 (15.4%) were positive for CMV DNA. Among the CMV DNA-positive patients, 119 (66.1%) remained without symptoms and 61 (33.9%) developed CMV-related symptoms. During the follow-up period, peak viral loads were significantly (P < .05) higher in symptomatic patients (mean 970 copies/mL; range, 15-625,000 copies/mL) than in asymptomatic patients (<150 copies/mL; range, 67-2,650 copies/mL). Many symptomatic patients (n = 57) were successfully treated, and their viral loads declined. However, some symptomatic patients had irregular viral-load kinetics, with prolonged periods of symptoms despite CMV treatment; we excluded the possibility of drug resistance in these patients, because there was no evidence of clinical resistance to treatment.
  
  
  CONCLUSIONS
  Quantitative real-time PCR of CMV DNA is useful in monitoring CMV infection and the effectiveness of CMV treatment in renal transplant recipients in Kuwait.
authors: Virology Unit, Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait. Electronic address: madi@hsc.edu.kw.
authors: N
authors: N
authors: Madi
authors: Virology Unit, Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait.
authors: M
authors: M
authors: Al-Qaser
authors: Virology Unit, Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait.
authors: R
authors: R
authors: Edan
authors: Virology Unit, Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait.
authors: W
authors: W
authors: Al-Nakib
mesh_terms: D000328:Adult; D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis*; D019468:Disease Management; D005260:Female; D006801:Humans; D015994:Incidence; D007730:Kuwait / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation; D060888:Real-Time Polymerase Chain Reaction; D019562:Viral Load / Q000706:statistics & numerical data*
chemical_list: D004279:DNA, Viral