Determining a Viral Load Threshold for Treating Cytomegalovirus (CMV)

"Group A: Start ganciclovir when CMV PCR \>200copies / ml x 2) . Participants are randomised to either Monitor or Treat. If monitored, treatment will only begin if viral load has increased \> 3,000. If treated (and monitored) treat until \<200 copies on 2 consecutive occasions.~Routine standard of care would include treatment of Valganciclovir 900mg Tablet BD (dose adjusted for renal impairment), Ganciclovir 5mg/kg BD IV, or Foscarnet 60mg/kg according to randomisation within Group A or Group B"

"Group A: CMV viral load between 200-3,000 copies/ml (on 2 occasions). Participants are randomised to either Monitor or Treat. If monitored, treatment will only begin if viral load has increased \> 3,000. If treated (and monitored) treat until \<200 copies on 2 consecutive occasions.~Routine standard of care would include treatment of Valganciclovir 900mg Tablet BD (dose adjusted for renal impairment), Ganciclovir 5mg/kg BD IV, or Foscarnet 60mg/kg according to randomisation within Group A or Group B"

"Group B: Viral load \> 3,000 copies/ml. Participants are randomised to treat until \< 3,000 copies/ml on 2 occasions or treat until \<200 copies/ml on 2 consecutive occasions.~Routine standard of care would include treatment of Valganciclovir 900mg Tablet BD (dose adjusted for renal impairment), Ganciclovir 5mg/kg BD IV, or Foscarnet 60mg/kg according to randomisation within Group A or Group B"

"Group B: Viral load \> 3,000 copies/ml. Participants are randomised to treat until \< 3,000 copies/ml on 2 occasions or treat until \<200 copies/ml on 2 consecutive occasions.~Routine standard of care would include treatment of Valganciclovir 900mg Tablet BD (dose adjusted for renal impairment), Ganciclovir 5mg/kg BD IV, or Foscarnet 60mg/kg according to randomisation within Group A or Group B"