Prognostic significance and risk factors of untreated cytomegalovirus viremia in liver transplant recipients

Andrew D. Badley, Robin Patel, Daniel F. Portela, William S. Harmsen, Thomas F. Smith, Duane M. Ilstrup, Jeffery L. Steers, Russell H. Wiesner, Carlos V. Paya

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

To study whether cytomegalovirus (CMV) viremia is a reliable marker of impending CMV disease and thus a guide for preemptive antiviral therapy, 126 consecutive liver transplant recipients were followed by routine CMV blood cultures in the absence of antiviral prophylaxis or treatment for viremia. Seventy-three patients (58%) developed CMV infections, and 36 (29%) had more than one infection episode: 29 patients (23%) had organ involvement and 45 (36%) had viremia. Within a same episode, CMV viremia was 90% sensitive and 80% specific for predicting concurrent organ involvement but preceded organ involvement in only 9 (31%) of 29 patients. In a separate analysis, untreated isolated CMV viremia in the first CMV infection episode was followed by organ involvement in a subsequent episode in 9 (33%) of 28 patients, mainly in the donor-positive, recipient-negative (D+/R-) population. The results indicate that CMV viremia is not an ideal marker to guide preemptive antiviral treatment in liver transplant recipients but is a good marker in D+/R- patients.

Original languageEnglish (US)
Pages (from-to)446-449
Number of pages4
JournalJournal of Infectious Diseases
Volume173
Issue number2
DOIs
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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    Badley, A. D., Patel, R., Portela, D. F., Harmsen, W. S., Smith, T. F., Ilstrup, D. M., Steers, J. L., Wiesner, R. H., & Paya, C. V. (1996). Prognostic significance and risk factors of untreated cytomegalovirus viremia in liver transplant recipients. Journal of Infectious Diseases, 173(2), 446-449. https://doi.org/10.1093/infdis/173.2.446