Definitions of cytomegalovirus disease after heart transplantation: Antigenemia as a marker for antiviral therapy |
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Authors: | Floria Iberer Karlheinz Tscheliessnigg Gabriele Halwachs Peter Rehak Andre Wasler Berthold Petutschnigg Günter Schreier Helmut Müller Thomas Allmayer Martina Ereigassner Günther Prenner Günther Hipmair Barbara Grasser |
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Affiliation: | (1) Department of Transplantation, Karl Franzens University of Graz, LKH, 1. Chirurgie, Fach 37, A-8036 Graz, Austria;(2) Department of Internal Medicine, Karl Franzens University of Graz, A-8036 Graz, Austria |
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Abstract: | In this prospective study, cytomegalovirus (CMV) antigenemia was defined as the marker for initiation and episodes of antigenemia as the indicator for the duration of antiviral therapy (CMV hyperimmune globulin and ganciclovir). The CMV antigenemia assay and CMV-specific IgM and IgG antibody tests were used to monitor CMV infection in 22 heart transplant recipients who, between October 1992 and July 1994, were followed up for 6 months. A total of 178 out of 627 antigenemia assays tested positive. The highest number of positive cells was greater after primary infection than after either reactivation (43.3 vs 0.3; P<0.01) or reinfection (43.3 vs 9.3; P=NS). Sixty episodes of antigenemia were observed. More episodes of antigenemia were seen after primary infection than after either reactivation (4.6 vs 0.2; P<0.01) or reinfection (4.6 vs 2.2; P=NS). The detection of antigenemia indicated the initiation of antiviral therapy within 24 h after the blood sample was harvested. Therapy was stopped immediately after a subsequent negative result became available. Our experience indicates that antigenemia directed antiviral therapy prevents CMV disease after primary and secondary infection in heart transplant recipients. |
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Keywords: | CMV, heart transplantation Heart transplantation, CMV Antigenemia, CMV |
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