Abstract
In a prospective study, the incidences of CMV infection and disease were 56 and 23%, respectively, during the first 6 months following kidney transplantation. Viremia was found in all patients with CMV disease and arthralgia was present in 71% prior to the development of CMV disease. The positive predictive value for CMV disease reached up to 90% for viremia and arthralgia in combination. Viruria was poorly correlated to viremia and hence CMV disease. The majority of patients (93%) who developed CMV disease had a seropositive donor, and viremia was significantly more common in patients who received CMV-seropositive kidneys. CMV disease was more common in CMV-seronegative recipients than in seropositive recipients. The 1-year graft survival rate was 75% in the entire study group. In patients with CMV viremia and disease, the rates were 78 and 73%, respectively. Antiviral treatment was initiated within 3 weeks of viremia detection in the 6 patients with CMV disease who survived. We found that the combination of arthralgia and viremia was a useful predictor of CMV disease and that recipients of CMV-seropositive allografts were at a greater risk of developing CMV disease. To obtain an early diagnosis and commence an early treatment...Continue Reading
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