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HF 6838

Cytomegalovirus (CMV) in the Transplant Patient

What is cytomegalovirus (CMV)?

Cytomegalovirus is often called just CMV. CMV is a common virus that can infect anyone of any age. Most people have had CMV by the time they reach an adult age. It only causes mild symptoms in people with healthy immune systems. They may feel sick for a day or two, and then feel better. 

Once CMV infects a person, the virus remains in your body for life, but a healthy immune system keeps the virus inactive. For transplant patients though, CMV can cause severe illness. The risk of CMV infection is highest during the first year because your immune system is weakened with high doses of anti-rejection medicines. But, you can have a CMV infection at any time. 

Can you prevent CMV?

You will take one of two medicines to prevent CMV infection after transplant. You will take Valganciclovir (Valcyte®) or Acyclovir (Zovirax®) after transplant. You will take this for about three to six months but can be longer. 

How did I get CMV?

CMV was most likely present in your body before the transplant. Because your immune system is weakened after transplant, CMV can reproduce in your blood. You were probably exposed at some point in your life but did not know it. You also may have been exposed to CMV through your donor.

Is it contagious? Do I need to worry about spreading it to other people?

There is a good chance that the people around you have already had the virus. You do not need to worry about spreading it to other people. One of the best ways to prevent CMV is to wash your hands.

What are the symptoms of CMV?

There are many symptoms of CMV. Just because you have the symptoms does not mean you have CMV. You could also be infected with CMV and not have any symptoms. Call your transplant coordinator if you have any of these symptoms:

  • Nausea

  • Vomiting

  • Diarrhea

  • Fever

  • General feeling of being unwell

  • Low white blood cell count

  • Fatigue

  • Muscle aches

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How do you know I have it? 

CMV is found by a blood test. Your transplant provider will test you for CMV based on your symptoms. 

What do I need to do about it?

  • Your transplant provider may reduce your anti-rejection medicines for a short time. This will help your body fight the CMV. 

  • You will be started on anti-viral treatment to help you fight CMV. This may be in the form of pills or an IV medicine. 

  • If you need IV medicine, you may need to stay in the hospital.

  • You may need to be seen in the transplant clinic within a short time after finding out you have CMV to see how severe your infection is and to figure out if the virus is causing damage to your lungs, liver, eyes or gastrointestinal system.

  • You may need to do blood (lab) tests at least once a week to check the CMV levels in your blood.

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How will you know when CMV is gone?

You will have your blood (lab) tests done to see if the virus is going away or getting stronger. We will check for CMV in your blood for a period of time after stopping the anti-viral medicines. We want to be sure that the CMV has not come back. Because the CMV stays in a person’s body for life, you can have CMV more than once.

If I have CMV, will my transplant be ok?

Although CMV can affect your transplant and other systems in your body, your doctor and coordinator will watch the virus closely. CMV can spread to other organ systems in your body. If left unchecked, it can be very serious. Most often, the anti-viral treatment can get rid of the virus before it causes a serious problem.