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JAC Advance Access originally published online on February 10, 2005
Journal of Antimicrobial Chemotherapy 2005 55(3):391-394; doi:10.1093/jac/dki031
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JAC vol.55 no.3 © The British Society for Antimicrobial Chemotherapy 2005; all rights reserved

A simplified strategy for clinical management of late cytomegalovirus infection after oral ganciclovir prophylaxis in renal recipients

Dirk R. J. Kuypers*, Kathleen Claes, Pieter Evenepoel, Bart Maes and Yves Vanrenterghem

Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium

* Corresponding author. Tel: +32-16-344580; Fax: +32-16-344599; Email: dirk.kuypers{at}uz.kuleuven.ac.be

Objectives: Late cytomegalovirus disease after completion of prophylactic therapy occurs in 5–21% of renal allograft recipients within the first year post-transplantation. Identifying patients at risk for late infection is clinically difficult; prolonged cytomegalovirus (CMV) monitoring is costly and cumbersome as follow-up intervals lengthen.

Patients and methods: We performed a prospective 1 year study in 54 de novo renal recipients to assess the minimum CMV monitoring frequency for identifying patients at risk.

Results and conclusions: CMV DNA PCR monitoring on the last day, and again 2 weeks after conclusion of oral ganciclovir prophylaxis, seemed sufficient for identifying recipients at risk for developing clinically relevant late CMV disease and for whom closer clinical follow-up is warranted.

Keywords: CMV infection , CMV disease , CMV prophylaxis , CMV monitoring , kidney transplantation


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