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Nephrol Dial Transplant (1992) 7: 1230-1237
© 1992 European Renal Association-European Dialysis and Transplant Association

research-article

Double-blind, placebo-controlled trial of human lymphoblastoid interferon prophylaxis of cytomegalovirus infection in renal transplant recipients

S. F. Lui1,*, A. A. Ali1, J. E. Grundy2, O. N. Fernando1, P. D. Griffiths2 and P. Sweny1,1

1Department of Nephrology and Transplantation The Royal Free Hospital London, UK 2Division of Communicable Diseases, The Royal Free Hospital London, UK

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr Paul Sweny, Department of Nephrology and Transplantation, The Royal Free Hospital, London NW3 2QG, UK.

We have conducted a double-blind, placebocontrolled trial of human lymphoblastoid interferonprophylaxis of cytomegalovirus (CMV) infection in 74 renal transplant recipients. Interferon (3 x 106 units was given thrice weekly for the first 6 weeks, then twice weekly for a further 8 weeks

During the period of interferon therapy, the incidence of CMV excretion was lower in the interferon group (28% versus 50%, p = 0.065), mainly due to a significant reduction of CMV reactivation (9% versus 56%, P = 0.02). However, for the whole study period (including the follow—up period after interferon therapy), there was no difference in the incidence of CMV excretion (44% versus 53%). The onset of CMV excretion was delayed (8.2 + 0.8 to 20.9 + 5.5 weeks, P = 0.04). The duration of CMV excretion was also reduced (11.1+3.1 to 29.4 + 5.7 weeks, P— 0.008). The number of positive CMV isolates from urine and saliva was significantly less in the interferon group. There was no difference in the site of CMV excretion.Of the patients in the treatment group who excreted CMV, 43% developed disease as compared to 63% in the control group (difference not significant). There was also no significant difference in the severity of the CMV infection between the two groups. Benefit appears to be restricted to seropositive recipients of seronegative kidneys.

The interferon regime used in this study was well tolerated, with mild fever being the only reported side-effect. No patient had to stop therapy because of toxicity. The incidence of rejection and graft loss was not different between the two groups.

Keywords: cytomegalovirus; interferon; prophylaxis; renal; transplant

* Current address: Department of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territory, Hong Kong.


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