Importance of cytomegalovirus (CMV) antigenemia in kidney transplantation

We performed a prospective study to evaluate the clinical usefulness of Human cytomegalovirus (HCMV) antigenemia assay for preemptive treatment after kidney transplantation. Asymptomatic patients with positive antigenemia were observed without specific antiviral therapy. Most patients were HCMV seropositive before transplantation (99.0%). Positive antigenemia assay was detected in 41 out of 97 eligible patients. Symptomatic CMV diseases were observed in 10 of 41 patients. HCMV-related symptoms and signs were significantly correlated with the level of antigenemia. All patients who had HCMV antigenemia titer of higher than 50 per 400,000 leukocytes developed HCMV-related symptoms and signs during the follow-up period. This criteria showed the highest positive predictive value and specificity in the development of symptomatic HCMV infection. In conclusion, the HCMV antigenemia titer can be used as a useful guide to the preemptive treatment of HCMV infection after kidney transplantation in HCMV-positive donors and recipients.