Cytomegalovirus detection in transplant patients: comparison of different methods in a prospective survey

In a prospective survey, all transplant patients at the hospital of the University of Zurich were screened for cytomegalovirus (CMV) infection. CMV infections were detected in a total of 40 of 104 transplant recipients; 31 could be diagnosed by CMV immunoglobulin M serology, 27 could be diagnosed by viremia, 11 could be diagnosed by antigenemia, and 13 could be diagnosed by the start of virus secretion. Combined application of serology and the detection of viremia showed the highest sensitivity (39 of 40 cases). Of the patients with severe clinical symptoms, six of seven had primary CMV infections caused by a positive transplant. Therefore, it is strongly indicated that patients with known risk factors should be regularly surveyed by a combination of methods.