Table 5: Characteristics of patients and monitoring of viral load in those receiving pre-emptive or therapeutic antiviral treatment.
|
No Patient |
Type of transplant |
Therapy |
Weeks of follow-up at beginning therapy (duration in weeks) |
Signs and symptoms |
Viral load (copies/mL) before therapy |
Viral load (copies/mL) after therapy |
|
|
ADULT RECIPIENTS |
|||||||
|
4 Au |
Bone marrow |
Acyclovir |
2 (1) |
Oral lesion |
No HSV viremia or viruria |
No virus detected |
|
|
14 Au |
Bone marrow |
Acyclovir |
0 (2) |
Trunk lesion |
JC urine: 8.2 × 103 |
No virus detected |
|
|
20 Al |
Bone marrow |
Valganciclovir |
7 (2) |
asymptomatic |
CMV viremia: 2.6 × 103 CMV urine: 8.7 × 102 BK urine: 1.9 × 107 |
No virus detected |
|
|
27 Au |
Bone marrow |
Acyclovir |
0 (1) |
Oral lesion |
HSV viremia: 2.2 × 107 |
No virus detected |
|
|
33 Au |
Bone marrow |
Acyclovir |
2 (1) |
Oral lesion |
No HSV viremia or viruria BK urine: 3.7 × 102 |
No virus detected |
|
|
79 Au |
Bone marrow |
Acyclovir |
0 (1) |
Genital lesion |
No HSV viremia or viruria |
No virus detected |
|
|
Valganciclovir |
3 (2) |
asymptomatic |
CMV viremia: 1.0 × 102 BK urine: 4.8 × 102 |
No virus detected |
|||
|
84 Al |
Bone marrow |
Valganciclovir Reduction of immunosupression |
8 (4) |
Hemorrhagic cystitis |
CMV urine: 2.1 × 104 BK urine: 1.1 × 108 |
BK urine: 2.2 × 103 |
|
|
90 Au |
Bone marrow |
Acyclovir |
2 (2) |
Oral lesion |
HSV viremia: 1.9 × 105 HSV urine: 1.1 × 104 |
No virus detected |
|
|
127 Al |
Bone marrow |
Valganciclovir |
4 (2) |
Hemorrhagic cystitis Fever, Graft rejection |
CMV urine: 1.6 × 103 JC urine: 2.4 × 103 |
No virus detected |
|
|
158 Au |
Bone marrow |
Acyclovir |
2 (1) |
Oral lesion |
No HSV viremia or viruria |
No virus detected |
|
|
181 Al |
Bone marrow |
Reduction of immunosupression |
2 (2) |
Hemorrhagic cystitis. Deceased |
BK urine: 2.1 × 106 |
BK urine: 5.6 × 108 |
|
|
21 |
Liver |
Ganciclovir + Valganciclovir |
4 (4) |
CMV syndrome, fever and digestive complications. Deceased |
CMV viremia: 1.6 × 104 CMV urine: 1.6 × 103 BK urine: 1.9 × 104 |
CMV viremia: 4.2 × 104 BK urine: 2.2 × 109 |
|
|
29 |
Liver |
Valganciclovir |
2 (2) |
Genital lesion |
HSV viremia: 1.4 × 106 HSV 2 urine: 3.8 × 107 CMV viremia: 1.3 × 103 |
No virus detected |
|
|
38 |
Liver |
Ganciclovir + Valganciclovir |
6 (1) |
CNS infection, graft rejection |
CMV viremia: 1.1 × 102 CMV CSF: 1.8 × 103 |
No virus detected |
|
|
76 |
Liver |
Valganciclovir |
12 (4) |
asymptomatic |
CMV viremia: 9.9 × 103 |
No virus detected |
|
|
91 |
Liver |
Valganciclovir |
0 (2) |
asymptomatic |
CMV viremia: 1.2 × 101 BK urine: 2.2 × 101 |
No virus detected |
|
|
93 |
Liver |
Acyclovir |
8 (1) |
Genital lesion |
No HSV viremia or viruria CMV urine: 1.0 × 102 |
No virus detected |
|
|
101 |
Liver |
Valganciclovir |
6 (1) |
Elevated AST, ALT |
CMV viremia: 9.9 × 104, BK urine: 4.8 × 104 |
No virus detected |
|
|
10 |
kidney |
Valganciclovir |
10 (4) |
asymptomatic |
CMV viremia: 4.6 × 103 CMV urine: 2.5 × 103 |
No virus detected |
|
|
11 |
kidney |
Reduction of immunosupression Valganciclovir |
2 (15) |
asymptomatic |
BK urine: 1.9 × 102 BK serum: 3.2 × 102 |
BK urine:1.3x105 |
|
|
13 (4) |
CMV viremia: 2.5 × 102 CMV urine: 7.3 × 102 |
||||||
|
26 |
kidney |
Acyclovir |
2 (2) |
Genital lesion |
HSV 2 urine: 1.6 × 104 |
No virus detected |
|
|
39 |
kidney |
Valganciclovir |
2 (1) |
Genital lesion and graft rejection |
No virus detected in serum or urine |
No virus detected |
|
|
43 |
kidney |
Acyclovir |
4 (4) |
Genital lesion |
HSV2 urine: 2.0 × 103 |
No virus detected |
|
|
Valganciclovir |
6 (4) |
asymptomatic |
CMV viremia: 3.5 × 102 CMV urine: 1.5 × 103 BK urine: 1.0 × 106 |
No virus detected |
|||
|
44 |
kidney |
Valganciclovir |
8 (4) |
asymptomatic |
CMV viremia: 1.9 × 104 CMV urine: 5.0 × 103 |
No virus detected |
|
|
57 |
kidney |
Valganciclovir |
6 (3) |
asymptomatic |
CMV viremia: 2.2 × 103 CMV urine: 1.0 × 107 |
No virus detected |
|
|
82 |
kidney |
Valganciclovir |
20 (4) |
asymptomatic |
CMV viremia: 5.3 × 103 CMV urine: 2.3 × 103 |
CMV urine: 5.1 × 104 |
|
|
83 |
kidney |
Valganciclovir |
10 (1) |
asymptomatic |
CMV viremia: 2.4 × 107 |
No virus detected |
|
|
87 |
kidney |
Reduction of immunosupression |
8 (4) |
asymptomatic |
BK urine: 9.7 × 106 |
BK urine: 5.4 × 109 |
|
|
Valganciclovir |
10 (3) |
asymptomatic |
CMV viremia: 2.5 × 103 CMV urine: 6.8 × 102 |
No virus detected |
|||
|
100 |
kidney |
Reduction of immunosupression |
8 (3) |
Hemorrhagic cystitis |
BK urine: 4.5 × 108 |
No virus detected |
|
|
148 |
kidney |
Valganciclovir |
0 (12) |
Fever and chronic reject |
CMV viremia: 8.4 × 106 CMV urine: 2.3 × 103 BK urine: 8.1 × 104 |
No virus detected |
|
|
198 |
kidney |
Valganciclovir |
2 (4) |
Fever, CMV syndrome |
CMV viremia: 1.2 × 108 CMV urine: 1.5 × 106 BK urine: 2.8 × 108 |
No virus detected |
|
|
PEDIATRIC RECIPIENTS |
|||||||
|
17 Al |
Bone marrow |
Valganciclovir Reduction of immunosupression |
2 (4) |
Hemorrhagic cystitis Deceased |
CMV urine: 1.2 × 102 BK urine: 2 × 102 |
CMV viremia: 2.1 × 103 CMV urine: 1.4 × 104 BK urine: 4.2 × 108 |
|
|
1 |
Liver |
Valganciclovir |
14 (4) |
asymptomatic |
CMV viremia: 1.8 × 103 |
No virus detected |
|
|
8 |
Liver |
Valganciclovir |
11 (4) |
asymptomatic |
CMV viremia: 2.4 × 104 |
No virus detected |
|
|
22 |
Liver |
Valganciclovir |
10 (10) |
Elevated AST, ALT |
CMV viremia: 1.3 × 104 EBV viremia: 1.0 × 101 |
No virus detected |
|
|
23 |
Liver |
Ganciclovir + Valganciclovir |
5 (5) |
Elevated AST, ALT |
CMV viremia: 3.1 × 104 CMV urine: 1.7 × 103 |
No virus detected |
|
|
12 |
Kidney |
Valganciclovir |
20 (4) |
asymptomatic |
CMV and BK viremia: 1.0 × 101 CMV urine: 2.4 × 102 BK urine: 1.1 × 107 |
CMV urine: 1 × 101 BK urine: 7.1 × 104 |
|
|
15 |
Kidney |
Valganciclovir |
20 (4) |
Fever |
CMV viremia: 3.4 × 102 CMV urine: 1.4 × 105 |
No virus detected |
|
|
4 (12) |
Fever and chronic reject. |
CMV viremia: 3.7 × 102 CMV urine: 1.8 × 106 |
CMV urine: 2.1 × 105 |
||||
|
18 |
Kidney |
Valganciclovir |
13 (11) |
Urinary infection |
CMV viremia: 1.1 × 102 |
No viremia |
|
|
CMV urine: 3.1 × 103 BK urine: 1.1 × 102 |
CMV urine: 102 |
||||||
Abbreviations: Au: Autologous, Al: Allogeneic, AST: Aspartate Aminotransferase, ALT: Alanine Aminotransferase, CNS: Central Nervious System, CMV: Cytomegalovirus, EBV: Epstein-Barr Virus; BK: BK Virus, JC: JC Virus, HSV: Herpes Simplex Virus