CONCISE COMMUNICATIONS High-Dose Oral Acyclovir Reduces the Incidence of Cytomegalovirus Infection in Liver Transplant Recipients

To determine the impact of high-dose oral acyclovir on cytomegalovirus (CMV) infection or disease after liver transplantation, CMV cultures were prospectively collected for 6 months after transplantation. The incidence and timing of infection and disease in patients receiving high-dose oral acyclovir (3200 mg/day) from day 7 until 3 months after transplantation were com-pared with an historical control group who received no acyclovir. All patients who did not receive acyclovir (group 1, n = 12) but only 57 % of those who did (group 2, n = 22) had CMV infection (P =.008). Nine (75%) group 1 but only 3 (14%) group 2 patients had positive leucocyte cultures (P =.0007). Three group 1 patients developed CMV disease; 1 group 2 patient developed CMV hepatitis. Each of these 4 patients had CMV viremia (P =.01). The frequency ofCMV infection after liver transplantation appears to be reduced by high-dose oral acyclovir. Cytomegalovirus (CMV) infection is a major cause ofmor-bidity and mortality in organ transplant recipients [1]. Pre-vious studies have shown that the incidence ofCMV disease in transplant patients can be decreased by prophylactic high-dose intravenous acyclovir [2], CMV immune globuli