Lodding I.P.,Center for Health and Infectious Disease Research |
Sengelov H.,Rigshospitalet Blegdamsvej 9 |
da Cunha-Bang C.,Center for Health and Infectious Disease Research |
Iversen M.,Rigshospitalet Blegdamsvej 9 |
And 9 more authors.
EBioMedicine | Year: 2015
Background: Cytomegalovirus (CMV) infection in transplant recipients is reported to replicate with a doubling time of 1.2-2. days, and weekly screening is recommended for early diagnosis. We re-evaluated these features in our cohort of transplant recipients. Methods: The CMV doubling time of the first CMV infection in the first year post-transplant could be calculated for 193 recipients of haematopoietic stem cell or solid organ transplantation. Factors determining the proportion of recipients with a high diagnostic CMV viral load (≥. 18,200. IU/mL) were explored using mathematical simulation. Findings: The overall median doubling time was 4.3. days (IQR 2.5-7.8) and was not influenced by prior CMV immunity, or type of transplantation (p. >. 0.4). Assuming a fixed doubling time of 1.3. days and screening intervals of 7 or 10. days, 11.1% and 33.3% were projected to have a high CMV viral load at diagnosis, compared to 1.4% and 4.3% if the doubling time varies as observed in our cohort. Consistently, 1.9% of recipients screened weekly had a high diagnostic virus load. Interpretation: Screening intervals can be extended to 10. days in cohorts with comparable CMV doubling time, whereas shorter than 7. days is required in cohorts with shorter doubling times to maintain pre-emptive screening quality. © 2015.