CONTROLLED CLINICAL-TRIAL OF PROPHYLACTIC HUMAN-LEUKOCYTE INTERFERON IN RENAL-TRANSPLANTATION - EFFECTS ON CYTOMEGALO-VIRUS AND HERPES-SIMPLEX VIRUS-INFECTIONS

A double-blind, placebo-controlled trial of interferon prophylaxis against viral infections was conducted in renal-transplant recipients receiving standard immunosuppressive therapy with or without antithymocyte globulin. Interferon was administered for six weeks, beginning on the day of transplantation. Cytomegalovirus excretion began earlier and viremia was more frequent in placebo-treated than in interferon-treated patients. Cytomegalovirus viremia correlated with clinical syndromes and was more frequent in recipients of antithymocyte globulin. In contrast, neither interferon nor antithymocyte globulin altered excretion of herpes simplex virus. Reversible leukopenia and thrombocytopenia occurred in seven interferon recipients. Patient and graft survival were comparable in interferon and placebo groups. These preliminary results suggest that a six-week course of prophylactic interferon delays shedding of cytomegalovirus and decreases the incidence of viremia after transplantation. In contrast, antithymocyte globulin appears to increase the severity of infection from cytomegalovirus among these patients. (N Engl J Med 300:1345–1349, 1979) THE most common infections complicating renal transplantation result from the herpes group of viruses, particularly herpes simplex virus and cytomegalovirus. Primary cytomegalovirus infection may be acquired after transplantation, most commonly from an allograft taken from a seropositive donor.1,2 In seropositive recipients, both cytomegalovirus and herpes simplex virus are often reactivated by immunosuppressive therapy or rejection of the transplant. The natural history and possible clinical impact of these two infections in recipients of renal transplants have received increasing attention.3 4 5 6 7 8 9 Herpes simplex virus is reactivated in the first few weeks after transplantation; the severity and duration of local lesions often exceed those. © 1979, Massachusetts Medical Society. All rights reserved.