Cytomegalovirus infection in dialysis patients

We have studied cytomegalovirus (CMV) infection in 197 patients on regular dialysis treatment and 170 healthy platelet donors. Evidence of past CMV infection was found significantly more often in patients than in controls (137 of 197 v 60 of 170; p less than 0.001) at the commencement of the study. During a 12 month period 4 of the 60 dialysis patients initially found to be seronegative, but none of the 110 seronegative controls, developed primary CMV infection. Five of the 137 dialysis patients and one of the 60 controls initially found to be seropositive showed evidence of recurrent infection. Typically, there was only a transient elevation of CMV IgM antibody titer in both primary and recurrent infection. However, one dialysis patient with recurrent infection and another 5 initially seropositive patients showed persistence of CMV:IgM antibody production suggesting that they were experiencing chronic active infection. Neither primary nor recurrent infection was invariably a consequence of transfusion of blood or blood products. There were no clear-cut clinical sequelae from any of the three forms of infection documented.