Infections with Cytomegalovirus and Other Herpesviruses in 121 Liver Transplant Recipients: Transmission by Donated Organ and the Effect of OKT3 Antibodies

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Abstract
One hundred twenty-one adult liver transplant recipients were studied for the incidence, risk factors, and morbidity associated with herpes viruses infections after transplantation. The overall incidence of infection was 59% for cytomegalovirus (CMV), 35% for herpes simplex virus (HSV), 25% for Epstein-Barr virus (EBV), and 7% for varicella-zoster virus (VZV). Primary CMV infection occurred in 46% and reactivation CMV infection in 67% of the susceptible recipients. Symptomatic and disseminated CMV diseases were more common when patients developed primary infection (P < .01, for both comparisons). The donor organ appeared to be the only important source of CMV infection in seronegative recipients. The use of OKT3 antibodies was associated with disseminated CMV disease in patients with primary infection (P = .04)but not with reactivation infection (P > .10). Although most HSV infections were oral or genital reactivations, three cases of HSV hepatitis occurred-one was a primary infection. Symptomatic reactivations of HSV were observed in 53% of HSV-seropositive recipients who received OKTJ, versus 31% of seropositive recipients who did not receive OKT3 (P = .05).