Usefulness of pp65 antigenemia and viremia in the follow-up of renal transplant recipients with cytomegalovirus disease treated with ganciclovir

We prospectively evaluated the usefulness of the pp65 antigenemia assay (AG A) and viremia (isolation) in the follow-up of 15 renal transplant recipien ts with a cytomegalovirus disease treated with ganciclovir. The AGA was per formed with the extraction of PMNL with saline dextran, and the viremia det ected by the inoculation of them in the MRC-5 cell line (shell-vial). Sixty -nine blood samples were studied, and 55 (79.7%) positive AGA and 42 (60.8% ) positive viremia detected. The AGA needed a median of 9 days to negativiz e, and the viremia only 4 days. In eight patients (53%) the AGA and viremia were negative simultaneously. In seven patients (47%) the viremia was nega tive before the AGA (median 10.7 days). In this group. three patients (43%) presented a paradoxal rising of the AGA values after the negativization of the viremia. For the follow-up of renal transplant recipients treated with ganciclovir, the viremia was the most useful method of control. The viremi a was negative before the AGA in many patients, demonstrating the therapeut ic efficacy of ganciclovir. (C) 2000 Elsevier Science Inc. All rights reser ved.