Primary cytomegalovirus and opportunistic infections. Incidence in renal transplant recipients

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Abstract
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 6 seronegative patients with seronegative tests, 4 (66%) experienced active CMV infection within 2 mo., and 4 died of Candida or Aspergillus infection within 6 mo. 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 related to primary CMV infection rather than to generalized immunodeficiency.