Monitoring of Cytomegalovirus Infection in Solid-Organ Transplant Recipients by an Ultrasensitive Plasma PCR Assay

Autor: Isabelle Binet, Gilles Mentha, Karine Hadaya, Luc Perrin, Werner Wunderli, Laurent Kaiser, Christelle Deffernez, Pierre-Yves Martin
Rok vydání: 2003
Předmět:
Microbiology (medical)
Time Factors
Polymerase Chain Reaction/methods
Congenital cytomegalovirus infection
Cytomegalovirus
medicine.disease_cause
Polymerase Chain Reaction
Sensitivity and Specificity
Herpesviridae
law.invention
Postoperative Complications
Kidney Transplantation/ adverse effects
Betaherpesvirinae
law
Virology
medicine
Humans
Cytomegalovirus Infections/blood/ diagnosis/epidemiology
Postoperative Period
Polymerase chain reaction
Kidney transplantation
Monitoring
Physiologic
ddc:616
Postoperative Complications/blood/ virology
biology
virus diseases
Cytomegalovirus/genetics/isolation & purification
biology.organism_classification
medicine.disease
Kidney Transplantation
Transplantation
surgical procedures
operative
Cytomegalovirus Infections
Monitoring
Physiologic/methods
Regression Analysis
Viral disease
Viral load
Follow-Up Studies
Zdroj: Journal of Clinical Microbiology, Vol. 41, No 8 (2003) pp. 3757-3764
ISSN: 1098-660X
0095-1137
DOI: 10.1128/jcm.41.8.3757-3764.2003
Popis: Early and accurate monitoring of cytomegalovirus (CMV) infection in solid-organ transplant recipients is of major importance. We have assessed the potential benefit of an ultrasensitive plasma-based PCR assay for renal transplant recipients. The pp65 CMV antigen (pp65 Ag) assay using leukocytes was employed as a routine test for the monitoring of CMV in 23 transplant recipients. We compared the pp65 antigenemia with the CMV load quantified by an ultrasensitive PCR (US-PCR) with a limit of detection of 20 CMV DNA copies/ml of plasma. CMV infection was detected in 215 (67%) of 321 plasma samples by the US-PCR compared with 124 (39%) of 321 samples by the pp65 Ag assay. The US-PCR assay permitted the detection of CMV infection episodes following transplantation a median of 12 days earlier than the pp65 Ag assay. Moreover, during CMV infection episodes, DNA detection by the US-PCR was consistently positive, whereas false negative results were frequently observed with the pp65 Ag assay. We found a good correlation between the two assays, and the peak viral loads were significantly higher in patients with CMV-related complications (median, 5,000 DNA copies/ml) than in those without symptoms (1,160 DNA copies/ml) ( P = 0.048). In addition, patients that did not require preemptive therapy based on the results of the pp65 assay had CMV loads significantly lower (median, 36 DNA copies/ml) than those that needed treatment (median, 4,703 DNA copies/ml) ( P < 0.001). These observations provided cutoff levels that could be applied in clinical practice. The ultrasensitive plasma-based PCR detected CMV infection episodes earlier and provided more consistent results than the pp65 Ag assay. This test could improve the monitoring of CMV infection or reactivation in renal transplant recipients.
Databáze: OpenAIRE
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