Relationship between IgM antibody to human cytomegalovirus, virus load, donor and recipient serostatus, and administration of methylprednisolone as risk factors for cytomegalovirus disease after liver transplantation

A retrospective study was performed on a selected cohort of 40 liver transp lant recipients derived from the previous prospective follow-up of 162 live r transplant patients. The criterion for selection of this cohort was the p resence of human cytomegalovirus (HCMV) DNAemia after transplantation, as d etermined by qualitative polymerase chain reaction (PCR), These 40 patients were followed longitudinally by quantitative PCR and by the new recombinan t antigen-based AxSYM immunoassay for IgM to HCMV, The detection of IgM to CMV after transplantation was significantly associated with the development of HCMV disease in patients who had evidence of active HCMV replication in the blood by PCR (P = .01), On the basis of multivariate logistic regressi on analyses, the maximum titer of IgM detected after transplantation was a risk factor that was independent of augmented methylprednisolone and donor seropositivity, However, in multivariate analyses, elevated virus load cont inued to be the predominant risk factor for progression to HCMV disease.