CYTOMEGALOVIRUS-INFECTION IN KIDNEY-TRANSPLANT PATIENTS - CLINICAL MANIFESTATIONS AND DIAGNOSIS

Cytomegalovirus (CMV) infection is an important cause of morbidity and mortality after solid organ transplantation. CMV infection after kidn ey transplantation was confirmed in 19 (54.3%) out of 35 patients. 16 of these (84.2%) developed CMV disease. CMV infection was diagnosed ba sed on a fourfold or greater increase of anti-CMV IgG antibody titre, detection of CMV-IgM antibodies and/or virus isolation. Primary infect ion was observed in 3 patients, reactivation in 9 and an undefined typ e of infection in 7. In most patients (63%), infection was diagnosed i n the first 2 months, and in 3 patients, after 3, 5 and 9 years follow ing kidney transplantation. The most frequent symptoms of CMV disease were fever (58%), pneumonitis (26.3%) and enterocolitis (15.8%). In 53 % of the patients, CMV infection co-occurred with other pathogens such as Candida albicans, Cryptococcus neoformans, bacteria or viruses (HB V, HCV, HSV). Treatment with polyvalent globulin (Sandoglobin) or hype rimmune globulin (Cytotect), in combination with ganciclovir in 7 pati ents, resulted in a regression of CMV disease.