TIME TO DETECTION OF CYTOMEGALOVIRUS (CMV) DNA IN BLOOD LEUKOCYTES ISA PREDICTOR FOR THE DEVELOPMENT OF CMV DISEASE IN CMV-SERONEGATIVE RECIPIENTS OF ALLOGRAFTS FROM CMV-SEROPOSITIVE DONORS FOLLOWING LIVER-TRANSPLANTATION

In 35 cytomegalovirus (CMV)-seronegative recipients of livers from CMV -seropositive donors, 32 (91%) developed CMV infection and 24 of them (75%) experienced disease. Polymerase chain reaction for CMV DNA in le ukocytes had the best positive and negative predictive values for the development of disease within 2 months from transplantation, and shell -vial or tube culture viremia was the best predictor thereafter. In pa tients who developed CMV disease, CMV DNA was first detected at 46 day s (median; range, 13-128) after transplantation, significantly earlier than the 77 days (range, 46-174) for those who did not develop CMV di sease (P = .02). By a semiquantitative method, the CMV DNA level in th e first positive sample did not predict disease development. However, the maximum CMV DNA level during infection was significantly higher in patients who developed CMV disease. In CMV-seronegative recipients of livers from CMV-seropositive donors, the time to DNA positivity follo wing transplantation may predict disease progression and be useful as a guide for the initiation of preemptive therapy.