HIGH-DOSE ORAL ACYCLOVIR REDUCES THE INCIDENCE OF CYTOMEGALOVIRUS-INFECTION IN LIVER-TRANSPLANT RECIPIENTS

To determine the impact of high-dose oral acyclovir on cytomegalovirus (CMV) infection or disease after liver transplantation, CMV cultures were prospectively collected for 6 months after transplantation. The i ncidence and timing of infection and disease in patients receiving hig h-dose oral acyclovir (3200 mg/day) from day 7 until 3 months after tr ansplantation were compared with an historical control group who recei ved no acyclovir. All patients who did not receive acyclovir (group 1, n = 12) but only 57% of those who did (group 2, n = 22) had CMV infec tion (P = .008). Nine (75%) group 1 but only 3 (14%) group 2 patients had positive leucocyte cultures (P = .0007). Three group 1 patients de veloped CMV disease; 1 group 2 patient developed CMV hepatitis. Each o f these 4 patients had CMV viremia (P = .01). The frequency of CMV inf ection after liver transplantation appears to be reduced by high-dose oral acyclovir.