Quantitative analysis of CMV DNA in children the first year after liver transplantation

Abstract

CMV infection is a major problem after solid organ transplantation especially in children where primary infection is more common than in adults. Early diagnosis is critical and might be facilitated by quantitative analysis of CMV DNA in blood. In this retrospective study of 18 children who had a liver transplantation 1995-2000, serum samples were analysed by Cobas Amplicor Monitor (Roche). Four patients developed symptomatic CMV infection at a mean time of 4 wk after transplantation. They showed maximum CMV DNA levels in serum of 26 400, 1900, 1300 and 970 copies/mL, respectively. In comparison, CA Monitor was positive, at a low level (415 copies/mL), in one of 11 patients with asymptomatic (4) or latent (7) infection. CMV IgM was detected at significant levels (> or =1/80) in all four patients with symptomatic, and in one with asymptomatic CMV infection. Eight patients were given one or several courses of ganciclovir. Five of these lacked symptoms of CMV disease, and had low (415 copies/mL) or undetectable CMV DNA in serum. The data suggest that quantitative analysis of CMV DNA may be of value in early identification of CMV disease and for avoiding unnecessary antiviral treatment.

Active human Cytomegalovirus infection and Glycoprotein B genotypes in Brazilian pediatric renal or hematopoietic stem cell transplantation patients

“…Human cytomegalovirus (HCMV) remains the most important cause of serious viral infections in pediatric transplant recipients (23). In these patients, early diagnosis of active HCMV infection is important, since the development of HCMV disease may be prevented (17).…”

Clinical Significance of Cytomegalovirus Infection in Pediatric Liver Transplant Recipients

“…Существенное влияние на тя-жесть течения инфекционного процесса оказывает стратегия профилактики ЦМВИ. По результатам ряда исследований, без применения специфической противовирусной профилактики ЦМВИ с характер-ной клинической картиной развивается у 22-60% пациентов в период 30-90 дней после транспланта-ции [19,25,26].…”

Current Prevention Strategies Against Cytomegalovirus in the Studies in Pediatric Liver Transplantation (SPLIT) Centers

“…Cytomegalovirus (CMV) is a significant posttransplant infection after pediatric liver transplant (PLT) with up to 30% of patients developing an episode of CMV infection or disease (1)(2)(3)(4). While prevention strategies can decrease the incidence of early posttransplant infections, the optimal strategy for CMV prevention is uncertain with limited literature in PLT recipients.…”