Effect of OKT3 antibody therapy on cytomegalovirus reactivation in renal transplant recipients

An OKT3-treated CMV-seropositive patient population showed a high incidence of CMV reactivation similar to that reported in connection with other forms of treatment for acute rejection such as ATG. On the other hand, CMV reactivation in our patients who receive only maintenance immunosuppression, as measured by serologic rise, occurs much less frequent in these patients than in those receiving OKT3, although it is likely that more intensive sampling would have revealed a few additional instances of viruria in both the groups studied. Despite the high viral reactivation rate in the OKT3 recipients, symptomatic CMV disease was infrequent. This indicates that with the current dosing regimen of OKT3 and maintenance immunosuppressives, CMV infection is a manageable complication of therapy, particularly if the intensity of immunosuppression is carefully monitored in those who have virologic evidence of CMV reactivation.