SERIAL MONITORING OF SOLUBLE INTERLEUKIN-2 RECEPTOR AS A RAPID MARKEROF CYTOMEGALOVIRUS-INFECTION AND RESPONSE TO ANTIVIRAL THERAPY

Serial sIL-2R serum levels were evaluated as an indicator of cytomegal ovirus infection and response to antiviral therapy. All cases of post- transplant CMV infection or disease were studied over a 2.5-year perio d with serial sIL-2R serum levels monitored daily post-transplant unti l discharge, during each inpatient admission and with each outpatient laboratory analysis. Mean sIL-2 levels +/-S.E.M. rose from a baseline level of 3662+/-321 U/ml to 11657+/-3311 U/ml at the time of diagnosis . Serum sIL-2R concentrations were significantly elevated from baselin e as early as 14 days prior to diagnosis of CMV, Mean peak sIL-2R leve ls occurred an average of 4 days after the initiation of ganciclovir t herapy and remained significantly elevated for an average of 20 days o f treatment. Serum sIL-2R levels in patients with resolved CMV returne d to within 20% of baseline after 20 days of therapy. These data suppo rt the idea that serial monitoring of sIL-2R serum levels may be usefu l adjunctively in the diagnosis of CMV as well as determining the resp onse to and duration of antiviral therapy.