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      Clinical Course of Cytomegalovirus (CMV) Viremia with and without Ganciclovir Treatment in CMV-Seropositive Kidney Transplant Recipients

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          This study was designed to evaluate the longitudinal history of cytomegalovirus (CMV) infection and to test the capacity of ganciclovir as effective therapy in CMV-seropositive renal transplant recipients. The CMV viremia was detected with CMV pp65 antigenemia assay in 153 renal transplants. The recipients were classified as having low-grade and high-grade CMV infections according to the severity of CMV infection. The recipients with low-grade CMV infections were observed without ganciclovir treatment, and the recipients with high-grade CMV infection were randomly assigned to ganciclovir-treated and untreated groups. The clinical course between low-grade and high-grade CMV infections was evaluated. All recipients with low-grade CMV infection (n = 62) showed spontaneous remission regardless of immunosuppresants. In high-grade CMV infection (n = 31), the ciclosporin A treated group (n = 11) showed no evidence of CMV disease, and the methylprednisolone-treated group (n = 8) showed CMV disease in 1 (25%) of 4 ganciclovir-untreated recipients. In the OKT3 group (n = 12), symptomatic CMV infection was observed in 6 (100%) ganciclovir-untreated recipients contrary to no CMV disease in the ganciclovir-treated group (p < 0.05). In conclusion, the CMV antigenemia assay is effective in monitoring CMV viremia, and ganciclovir treatment should be done during early CMV viremia in OKT3-treated recipients.

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          Author and article information

          Am J Nephrol
          American Journal of Nephrology
          S. Karger AG
          October 1998
          10 September 1998
          : 18
          : 5
          : 373-378
          a Division of Nephrology, Department of Internal Medicine, b Department of Surgery, and c Research Laboratory of Renal Diseases, Kangnam St. Mary’s Hospital, Catholic University Medical College, Seoul, South Korea
          13379 Am J Nephrol 1998;18:373–378
          © 1998 S. Karger AG, Basel

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          Page count
          Figures: 5, Tables: 2, References: 21, Pages: 6
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