Incidence of cytomegalovirus infections in renal transplant patients treated with conventional or cyclosporin therapy.

The incidence and severity of cytomegalovirus (CMV) infection was examined in groups of consecutive renal transplant patients: group A (50 patients) transplanted from August 1984 to October 1985 received cyclosporin (from the day of transplantation) and steroid therapy; group B (50 patients) transplanted between June and July 1984 received conventional therapy (azathioprine and steroids, and antilymphocyte globulin for 14 days). In groups A and B there were respectively 5 (10%) and 14 (28%) seronegative patients prior to transplantation (CMV antibody titre less than 128 by ELISA); the overall incidence of CMV was 38% vs 74% (P less than 0.001); the incidence of primary infection was 0% (0 of 5) vs 36% (5 of 14) (NS); the incidence of secondary infection was 42% (19 of 45) vs 89% (32 of 36) (P less than 0.00001); and the total incidence of symptomatic infection was 10% vs 26% (P = 0.04). Thus we conclude that initial cyclosporin therapy leads to a reduction in CMV infection.