IMMUNOLOGIC RESPONSE TO CYTOMEGALOVIRUS INFECTION IN RENAL ALLOGRAFT RECIPIENTS1

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Abstract
Craighead, J. E. (College of Medicine, Univ. of Vermont, Burlington, Vt.). Immunologic response to cytomegalovirus infection in renal a I log raft recipients. Amer. J. Epid., 1969, 90: 506–513.—Cytomegalovirus (CMV) infection was established by serologic means in 60% of renal allograft recipients undergoing transplantation at the Peter Bent Brig ham Hospital over a four-year period. Evidence of infection was not found during the month immediately following surgery; it usually appeared during the subsequent five months. More than half of the patients who possessed no serologic evidence of CMV infection before transplantation developed significant levels of antibody after the procedure. The data suggest that infection may have occurred as a result of environmental exposure to CMV in the hospital or clinic. Substantial increases in CF titer were demonstrated in the majority of allograft recipients having serum antibody at the time of transplantation. It is assumed that these patients experienced an exacerbation of “latent” virus. Evidence is presented which suggests that the antibody response is altered in some patients developing CMV infection during periods of immunosup-pressive treatment. Falling levels of CF or neutralization antibody or both were demonstrated in all but one of 11 patients who died with generalized CMV infection. Neutralization tests showed that most patients developed antibody which was reactive with three established strains of CMV.

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