Human Cytomegalovirus (HCMV) Infection in Organ Transplant Recipients / 감염

ABSTRACT

BACKGROUND: Human cytomegalovirus (HCMV) is not eradicated from a host after a primary infection and persists in a latent form. When the immunological condition of the host is compromised, the virus can be reactivated and cause serious disease. Given that the prevalence of anti-HCMV IgG antibody positivity is over 95% in Korean adult population, the transplant recipients in Korea are likely to be a high risk of developing HCMV infection and diseases. METHODS: Fourteen bone marrow recipients, 44 kidney transplant recipients and 4 liver transplant recipients were evaluated for excretion of HCMV. Urine and blood were cultured by conventional method at the time of transplantation and at regular intervals thereafter. To evaluate sensitivity and specificity of shell vial assay for detecting HCMV, the specimens from 41 transplant recipients were cultured by using both shell vial assay and conventional virus culture. RESULTS: The frequency of HCMV infection was 50%(7/14) in allogeneic bone marrow (BM) recipients, 36%(16/44) in kidney recipients and 25%(1/4) in liver transplant recipients. HCMV diseases were observed in only 3 cases; 3 BM recipients developed interstitial pneumonitis. Sensitivity and specificity of shell vial assay for the detection of HCMV was 50%(3/6) and 91%(32/35), respectively. CONCLUSION: HCMV infections in organ transplant recipients were relatively common in Korea. HCMV started to be excreted in urine about 1 month after transplantation and were found in 33-50% of all recipients later on. Sensitivity of shell vial assay was so low that it needs to be complemented with other diagnostic methods.