Evaluation by Immune Scanning Electron Microscopy of Foscarnet Treatment of Cytomegalovirus Infection in Patients with Renal Transplants

Abstract

Eight patients, 7 renal and 1 combined renal and pancreas allograft recipients with generalized cytomegalovirus (CMV) infection were treated with continuous intravenous foscarnet infusion (0.15 mg/kg/min) for 10–14 days. Antiviral effect was studied by immune scanning electron microscopy for detection of CMV antigen in serum and urine, by virus isolation in tissue culture in samples from buffy coat, broncholavage and urine and by serology. CMV antigen was detected in serum samples in 8 patients and 5 had positive virus isolation from buffy coat, before institution of therapy. The 3 patients with negative virus isolation in tissue culture had serological evidence of a reactivated CMV infection. Virus replication was inhibited by foscarnet treatment in 7 patients within a week (p < 0.01) (Wilcoxon log rank test). 7/8 patients had no detectable CMV antigen in serum or urine after 7–10 days of treatment (p < 0.01) (Wilcoxon log rank test).