MONITORING OF RENAL-ALLOGRAFT RECIPIENTS BY QUANTITATION OF HUMAN CYTOMEGALOVIRUS GENOMES IN PERIPHERAL-BLOOD LEUKOCYTES

The ratio of human cytomegalovirus (HCMV) genomes per cellular genomes in serial peripheral blood leukocyte (PBL) extracts of renal allograf t recipients was quantitated by competitive nested polymerase chain re action (PCR). Patients were also monitored for the development of acut e HCMV infection by detection of HCMV pp65 antigenemia, HCMV IgM antib odies, and viruria. Compared to qualitative nested HCMV PCR, the frequ ency of positive PCR results in renal allograft recipients without fur ther evidence of acute HCMV infection was significantly reduced by qua ntitative HCMV PCR. HCMV DNA levels greater than or equal to 1,000 cop ies HCMV/10(6) copies beta -globin were found to be highly indicative for the development of a clinically symptomatic HCMV infection followi ng renal allograft transplantation. In patients treated with ganciclov ir, quantitation of HCMV target sequences allowed the assessment of th e efficacy of antiviral therapy. (C) 1994 Wiley-Liss, Inc.