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November 24, 1978

Primary Cytomegalovirus and Opportunistic Infections: Incidence in Renal Transplant Recipients

Author Affiliations

From the Department of Medicine, University of California, Irvine (Dr Fiala and Ms Stacey), Departments of Medicine (Dr Weiner), Surgery (Dr Chatterjee), and Pathology (Dr Warner), University of Southern California School of Medicine, Los Angeles, and Center for Disease Control, Atlanta (Dr Stewart).

JAMA. 1978;240(22):2446-2449. doi:10.1001/jama.1978.03290220058017

Thirty-five renal allograft recipients were studied concerning the relationship between cytomegalovirus (CMV), herpes simplex virus (HSV), and opportunistic bacterial and fungal infections. The incidence of opportunistic infections was determined for patients whose tests prior to transplantation were seronegative in complement fixation and indirect hemagglutination assays of CMV antibody and for those patients whose tests were seropositive. Among the six seronegative patients with seronegative tests, four (66%) experienced active CMV infection within two months, and four died of Candida or Aspergillus infection within six months after transplantation. Among the 22 patients with seropositive tests, only one (4%) had a fungal infection and it was nonfatal (P<.05). The increased morbidity and mortality due to fungal and bacterial infections in transplant recipients with seronegative CMV tests appears, therefore, to be related to primary CMV infection rather than to generalized immunodeficiency.

(JAMA 240:2446-2449, 1978)