Recurrent cytomegalovirus disease in solid-organ transplant recipients.

Recurrent CMV disease has been reported to occur in 6% to 59% of solid-organ transplant recipients. The consequences of recurrent CMV disease after the treatment of the first CMV disease episode in patient and graft survival have not been fully elucidated. Additionally, few epidemiologic data are available regarding predictors of recurrent CMV disease. In three of four studies that investigated predictors for recurrent CMV disease, primary CMV infection (D+/R-) was associated with a higher rate of recurrent CMV disease among liver, intestinal, and solid-organ transplant recipients in general. Antirejection therapy was associated with recurrent CMV disease in two of three studies that examined this variable as a possible predictor of recurrent CMV disease. Further studies are needed to define the subgroup of solid-organ transplant recipients at higher risk for recurrent CMV disease, for whom more intensive or novel prophylactic, therapeutic, or diagnostic cost-effective strategies are warranted.