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Advances in Cytomegalovirus Diagnostic Testing and Their Implications for Management of Cytomegalovirus Infec tion in Transplant Recipients

  • Chapter
Infectious Complications in Transplant Recipients

Part of the book series: Perspectives on Critical Care Infectious Diseases ((CCID,volume 1))

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Abstract

Human cytomegalovirus (CMV) was the first “opportunistic” virus described in renal transplant recipients under azathioprine and prednisone (1). It has been the most frequent cause of infectious complications after whole organ transplantation with all subsequent immunosuppressive regimens (2-11). In seronegative recipients, latently infected allografts and leukocyte-containing blood products are documented means of virus transmission (12-16). Among pre-transplant CMV seropositive transplant recipients, CMV infection may occur after reactivation of latent infection or after reinfection (17). Coinfection with multiple strains has also been detected in immunocompromised individuals (18-20). These so called secondary infections occur in about 50% to 80% of pre-transplant seropositive transplant recipients but a smaller proportion of the patients, ranging from 10 to 40% according to the transplanted organ, develop a CMV disease (11). Active CMV infection occurs during the first three months after transplantation and may be accompanied by a broad spectrum of disease manifestations ranging from a mononucleosis like syndrome to severe pneumonia. In the scientific literature the definitions used for CMV infection, CMV viremia and CMV disease vary greatly. Since this can make comparison between different studies difficult, a consensus definition was achieved during the fourth and fifth CMV conference in Paris 1993 and Stockholm 1995 (21).

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  1. Istituto di Clinica delle Malattie Infettive, IRCCS San Matteo - Università di Pavia, Pavia, 27100, Italy

    Paolo Grossi

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  1. Paolo Grossi
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  1. Infectious Diseases Section, Veterans Affairs Medical Center, Pittsburgh, Pennsylvania, USA

    Nina Singh M.D.

  2. Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

    Nina Singh M.D.

  3. Infectious Diseases Unit, Department of Microbiology, Hospital “12 de Octubre”, Av de Andalucia km 5,400, Madrid, E-28041, Spain

    José M. Aguado M.D.

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Grossi, P. (2001). Advances in Cytomegalovirus Diagnostic Testing and Their Implications for Management of Cytomegalovirus Infec tion in Transplant Recipients. In: Singh, N., Aguado, J.M. (eds) Infectious Complications in Transplant Recipients. Perspectives on Critical Care Infectious Diseases, vol 1. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1403-9_6

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