THE DIAGNOSIS AND TREATMENT OF CYTOMEGALOVIRUS INFECTION AFTER RENAL TRANSPLANTATION / 解放军医学杂志

ABSTRACT

To study the diagnosis of cytomegalovirus (CMV) infection after renal transplantation and the effects and side effects of preventive use of foscarnet (PFA). ELISA assay was used to determine active CMV infection (IgM+,IgG+) and inactive CMV infection (IgM-,IgG+). Seventy four cases of active CMV infection and 25 of inactive CMV infection were selected to receive PFA treatment. Besides, 10 cases of inactive CMV infection without PFA treatment served as a control group. The results showed that the serological tests turned negative in subclinical patients in active stage after 12 5 days of treatment. In those patients with clinical symptoms, infection was controlled in 34 patients after 15 days of treatment. In another 2 patients, serology turned negative after 1 month of treatment, and no recurrence found one year later. In patients in inactive stage, IgM became positive, but with no symptoms, one year after treatment. At the same time, 3 patients in the control group turned into active infection after 1, 2 and 3 months. The results suggested ELISA assay was a good method to determine serum CMV IgG and IgM at present; PFA could definitively control active CMV infection quickly, and no recurrence was found during 1 year follow up; PFA might prevent reversion of serological indexes in patients with inactive infection. Moreover, PFA did not impose damage to the function of the renal graft, and nor interfered with the metabolism of blood calcium and cyclosporine A. Thus, PFA is a safe and effective drug to treat CMV infection.