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Understanding Viral Load Assays for Cytomegalovirus and Epstein-Barr Virus


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CMV in Transplant Patients

Slide 4

March 2010

Patients receiving a solid organ are most at risk for CMV in the first few months following the transplant, or following the end of antiviral prophylaxis. In fact, a substantial percentage of transplant patients would develop symptomatic disease if prophylactic or preemptive therapy were not employed. The most common manifestations for CMV disease in this population is gasteroenteritis and retinitis, but CMV syndrome is also common, resulting in nonspecific symptoms such as fever, weakness, myalgia, and myelosuppression.

Stem cell transplant patients will often present with CMV syndrome or pneumonia, and are also at highest risk within the first few months following transplant.

Although it is thought that some cases of tissue-invasive disease can produce high viral loads, it is important to bear in mind that viral loads may be negative for infections that are localized to a single tissue, or to the transplanted organ. Therefore, a negative viral load does not preclude the diagnosis of tissue-invasive disease. Symptoms consistent with localized CMV infection, combined with a negative viral load may be reason to pursue alternative strategies, such as a biopsy.

CMV in Transplant Patients


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