Repeated CMV Infection in a Heart Transplantation Patient

Table 1

	2001	2001	2002	2004	2004	2005	2010	2010	2012
Event	HTx	3 rejections	Retinitis	Protocol change	Retinitis	Retinitis	Diarrhea	Retinitis; pneumonia	None
Immunosupresion	OKT3; CsA; Aza; Ster.	Steroids boluses	CsA; Aza; Steroids	CsA; Aza → MMF; Steroids	CsA; MMF; Steroids	↓ CsA; ↓ MMF; Steroids	Csa → Eve; MMF; Steroids	Eve; Steroids	Eve; Steroids
CMV (blood)	R IgG+; D IgG+	Positive Ag.	Negative Ag.	Negative Ag.	Negative Ag.	Positive Ag.	525,000 copies	425,000 copies	Negative
Treatment; CMV	None	Ganciclovir oral	Aciclovir iv Aciclovir oral	None	Aciclovir iv; VGC	VGC	VGC	VGC; Foscarnet iv; Foscarnet intraocular	VGC prophylactic

HTx: heart transplantation; CsA: cyclosporine; Aza: azathioprine; MMF: mycophenolate mofetil; Ag: antigenemia; Eve: everolimus; VGC: valganciclovir.