Monitoring antigenemia is useful in guiding treatment of severe cytomegalovirus disease after organ transplantation

Abstract

We investigated the value of monitoring CMV antigenemia during and after antiviral therapy for CMV disease. During the study period, 10 out of 214 renal transplant recipients were treated for CMV disease, receiving a total of 14 courses of treatment. Antigenemia decreased within 7 days after onset of treatment in eight of nine courses associated with a rapid clinical recovery. In three courses with a slow or absent response, antigenemia levels initially increased. Monitoring antigenemia was helpful in differentiating persisting CMV disease from other opportunistic infections and rejection. Relapses of CMV disease were preceded by rises in antigenemia. Viral isolation became negative within 3 days after initiation of ganciclovir, irrespective of the clinical response. Antigenemia is a marker of the effect of ganciclovir on CMV replication in vivo, and its monitoring may be valuable in the management of patients with severe CMV disease.

Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis

“…The CMV antigenemia assay detects the CMV pp65 antigen in circulating polymorphonuclear neutrophils (PMNs) in the blood by staining with fluorescent antibodies that are specific for pp65 antigens. 4 Previous studies have shown that this semiquantitative technique is useful for diagnosing and monitoring CMV infection in immunocompromised patients, such as bone marrow 6 and solid organ (e.g., kidney and liver) transplant recipients, 7 , 8 , 9 or those with acquired immunodeficiency syndrome (AIDS). 10 , 11 Furthermore, CMV antigenemia-guided pre-emptive ganciclovir therapy was effective in patients who received allogenic hematopoietic stem cell transplantation.…”