Infection of Cytomegalovirus(CMV) is clinically either silent or mild in a healthy individual, however, may present serious problems in the immunoderpressive patients. The renal transplant patients may show elevated CMV antibody titer during
immunosuppressive therapy and some of the affected patients may reveal an active symptomatic illness(CMV disease).
In the renal transplant recipients, distinguishing CMV disease from rejection may be difficult, because the viral infection can cause renal insufficiency as well and the diagnosis of te infection present a clinical dilemma. Seroconversion dose
not
occur
before three to six weeks after CMV infection and culture of the virus takes several weeks Early diagnosis of CMV in fection can be done by shell vial culture in 48 hours utilizing an indirect immunofluorescence.
To compare with CMV serologic tests and evaluate the effects on the posttransplant renal fucntions, the CMV detection using shell vial cultures was done in 27 patients who underwent renal transplanion at the Chonnam University Hospital from
October,
1987 to February, 1994.
@ES The results were as follows:
@EN 1) In CMV IgG test, all 27 cases were positive.
2) In CMV IgM test, 11 cases were positive and 10 negative.
3) By shell vial cultures, CMV was detected in 2 cases out of 11 CMV IgM positive patents and 3 cases from 16 negative patients.
4) The seropositive(11 cases) and the positive shell vial assay(5 cases) patients failed to demonstrate any effects on the posttransplant reanal funcitions and the incidence of acute rejection and did not show any clinical symptoms such as
fever,
malaise, arthritis or pneumonia.
In conclusion, the positive detection of CMV appears to be essential to make, but not necessarily to establish the diagnosis of clinical CMV disease.
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