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JAC Advance Access published online on February 10, 2005
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dki031
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JAC © The British Society for Antimicrobial Chemotherapy 2005; all rights reserved
Received September 28, 2004
Revised December 4, 2004
Accepted December 22, 2004

Brief report

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

Dirk R. J. Kuypers 1*, Kathleen Claes 1, Pieter Evenepoel 1, Bart Maes 1, and Yves Vanrenterghem 1

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

* To whom correspondence should be addressed.
Dirk R. J. Kuypers, E-mail: Dirk.Kuypers{at}uz.kuleuven.ac.be


  Abstract

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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