[Treatment of cytomegalovirus infections in renal transplants]

Primary cytomegalovirus (CMV) disease can be prevented in renal transplant recipient with the use of either CMV hyperimmune globulin or acyclovir. When started before transplantation and continued for 12 to 16 weeks, these treatments decrease significantly the incidence of primary CMV disease. However they are not always effective and their effectiveness for the prevention of CMV reinfection or reactivation has not been established. Other prophylactic methods, such as vaccination or interferon alpha are not effective. Ganciclovir has been shown to be effective for the treatment of overt CMV disease, provided it is administered early. Combined treatments with CMV hyperimmune globulins and ganciclovir can be used in the most severe forms of the disease. Foscarnet can also be effective, however its nephrotoxicity limits its use in renal transplant recipients.