Abstract
A total of 3,552 specimens for conventional cytomegalovirus (CMV) culture and shell vial assay for CMV immediate-early antigen were obtained during a prospective randomized trial for prophylaxis of CMV disease after liver transplantation. Prophylaxis with ganciclovir for 2 weeks and then high-dose acyclovir for 2.5 months was compared with high-dose acyclovir alone for 3 months. During the first 12 weeks after transplantation, when the patients were on prophylaxis, there were significantly more clinical samples positive by the shell vial assay and negative by standard culture in comparison with the number of samples obtained from weeks 13 to 24, after prophylaxis was discontinued, that were positive by the shell vial assay and negative by standard culture. In contrast, significantly fewer samples were positive by both the shell vial assay and standard culture during the first 12 weeks compared with the number obtained 13 to 24 weeks after transplantation that were positive by both methods. Samples positive by the shell vial assay only were obtained significantly more frequently from patients with asymptomatic than symptomatic CMV infections, while samples positive by both methods were obtained significantly more often from patients with symptomatic CMV infection. It was concluded that antiviral prophylaxis with high-dose acyclovir or ganciclovir and then high-dose acyclovir and asymptomatic CMV infection are associated with a decrease in the level of CMV isolation by standard cell culture in comparison with that by the shell vial assay.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Balfour H. H., Jr, Chace B. A., Stapleton J. T., Simmons R. L., Fryd D. S. A randomized, placebo-controlled trial of oral acyclovir for the prevention of cytomegalovirus disease in recipients of renal allografts. N Engl J Med. 1989 May 25;320(21):1381–1387. doi: 10.1056/NEJM198905253202105. [DOI] [PubMed] [Google Scholar]
- Blum M. R., Liao S. H., de Miranda P. Overview of acyclovir pharmacokinetic disposition in adults and children. Am J Med. 1982 Jul 20;73(1A):186–192. doi: 10.1016/0002-9343(82)90088-2. [DOI] [PubMed] [Google Scholar]
- Fletcher C., Sawchuk R., Chinnock B., de Miranda P., Balfour H. H., Jr Human pharmacokinetics of the antiviral drug DHPG. Clin Pharmacol Ther. 1986 Sep;40(3):281–286. doi: 10.1038/clpt.1986.177. [DOI] [PubMed] [Google Scholar]
- Fryd D. S., Peterson P. K., Ferguson R. M., Simmons R. L., Balfour H. H., Jr, Najarian J. S. Cytomegalovirus as a risk factor in renal transplantation. Transplantation. 1980 Dec;30(6):436–439. doi: 10.1097/00007890-198012000-00010. [DOI] [PubMed] [Google Scholar]
- Gerna G., Revello M. G., Percivalle E., Zavattoni M., Parea M., Battaglia M. Quantification of human cytomegalovirus viremia by using monoclonal antibodies to different viral proteins. J Clin Microbiol. 1990 Dec;28(12):2681–2688. doi: 10.1128/jcm.28.12.2681-2688.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gerna G., Zipeto D., Parea M., Revello M. G., Silini E., Percivalle E., Zavattoni M., Grossi P., Milanesi G. Monitoring of human cytomegalovirus infections and ganciclovir treatment in heart transplant recipients by determination of viremia, antigenemia, and DNAemia. J Infect Dis. 1991 Sep;164(3):488–498. doi: 10.1093/infdis/164.3.488. [DOI] [PubMed] [Google Scholar]
- Gleaves C. A., Smith T. F., Shuster E. A., Pearson G. R. Comparison of standard tube and shell vial cell culture techniques for the detection of cytomegalovirus in clinical specimens. J Clin Microbiol. 1985 Feb;21(2):217–221. doi: 10.1128/jcm.21.2.217-221.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Griffiths P. D., Panjwani D. D., Stirk P. R., Ball M. G., Ganczakowski M., Blacklock H. A., Prentice H. G. Rapid diagnosis of cytomegalovirus infection in immunocompromised patients by detection of early antigen fluorescent foci. Lancet. 1984 Dec 1;2(8414):1242–1245. doi: 10.1016/s0140-6736(84)92797-1. [DOI] [PubMed] [Google Scholar]
- Grundy J. E., McKeating J. A., Ward P. J., Sanderson A. R., Griffiths P. D. Beta 2 microglobulin enhances the infectivity of cytomegalovirus and when bound to the virus enables class I HLA molecules to be used as a virus receptor. J Gen Virol. 1987 Mar;68(Pt 3):793–803. doi: 10.1099/0022-1317-68-3-793. [DOI] [PubMed] [Google Scholar]
- Janssen H. P., van Loon A. M., Meddens M. J., Eickmans-Josten E. C., Hoitsma A. J., de Witte T. J., Quint W. G. Immunological detection of cytomegalovirus early antigen on monolayers inoculated with urine specimens by centrifugation and cultured for 6 days as alternative to conventional virus isolation. J Clin Microbiol. 1988 Jul;26(7):1313–1315. doi: 10.1128/jcm.26.7.1313-1315.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lee F. K., Nahmias A. J., Stagno S. Rapid diagnosis of cytomegalovirus infection in infants by electron microscopy. N Engl J Med. 1978 Dec 7;299(23):1266–1270. doi: 10.1056/NEJM197812072992302. [DOI] [PubMed] [Google Scholar]
- McKeating J. A., Griffiths P. D., Grundy J. E. Cytomegalovirus in urine specimens has host beta 2 microglobulin bound to the viral envelope: a mechanism of evading the host immune response? J Gen Virol. 1987 Mar;68(Pt 3):785–792. doi: 10.1099/0022-1317-68-3-785. [DOI] [PubMed] [Google Scholar]
- Paya C. V., Wold A. D., Smith T. F. Detection of cytomegalovirus infections in specimens other than urine by the shell vial assay and conventional tube cell cultures. J Clin Microbiol. 1987 May;25(5):755–757. doi: 10.1128/jcm.25.5.755-757.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Popow-Kraupp T., Kunz C. Detection of cytomegalovirus in clinical specimens by virus isolation and by a monoclonal antibody against the early nuclear antigen. J Med Virol. 1988 Mar;24(3):275–282. doi: 10.1002/jmv.1890240305. [DOI] [PubMed] [Google Scholar]
- Revello M. G., Percivalle E., Zavattoni M., Parea M., Grossi P., Gerna G. Detection of human cytomegalovirus immediate early antigen in leukocytes as a marker of viremia in immunocompromised patients. J Med Virol. 1989 Oct;29(2):88–93. doi: 10.1002/jmv.1890290204. [DOI] [PubMed] [Google Scholar]
- Simmons R. L., Lopez C., Balfour H., Jr, Kalis J., Rattazzi L. C., Najarian J. S. Cytomegalovirus: Clinical virological correlations in renal transplant recipients. Ann Surg. 1974 Oct;180(4):623–634. doi: 10.1097/00000658-197410000-00028. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Singh N., Yu V. L., Mieles L., Wagener M. M., Miner R. C., Gayowski T. High-dose acyclovir compared with short-course preemptive ganciclovir therapy to prevent cytomegalovirus disease in liver transplant recipients. A randomized trial. Ann Intern Med. 1994 Mar 1;120(5):375–381. doi: 10.7326/0003-4819-120-5-199403010-00004. [DOI] [PubMed] [Google Scholar]
- van den Berg A. P., van der Bij W., van Son W. J., Anema J., van der Giessen M., Schirm J., Tegzess A. M., The T. H. Cytomegalovirus antigenemia as a useful marker of symptomatic cytomegalovirus infection after renal transplantation--a report of 130 consecutive patients. Transplantation. 1989 Dec;48(6):991–995. doi: 10.1097/00007890-198912000-00019. [DOI] [PubMed] [Google Scholar]
