Abstract
This study compared PCR and an assay for cytomegalovirus (CMV) pp65 antigenemia (CMV-vue; INCSTAR Corp.) with a quantitative shell vial culture (QSVC) technique for the detection of CMV in serial blood specimens from 46 solid-organ transplant recipients. In a comparison based on 535 specimens tested by PCR and QSVC, CMV was detected by PCR in 41 and by QSVC in 37 of 43 recipients at risk of CMV infection. The mean number of days after transplantation of initial detection of CMV was 29.9 for PCR and 34.0 for QSVC (P = 0.01). The antigenemia assay was performed on 395 specimens, including 304 of those also tested by PCR. In these specimens, CMV was detected by the antigenemia assay, QSVC, and PCR in 30, 32, and 35 (respectively) of 38 patients at risk, with no statistically significant difference in the time to detection. Each of the assays detected CMV in similar proportions of patients with and without clinically significant CMV infection. PCR stayed positive longer after transplantation than the other assays but frequently returned to negative when more than 6 months had elapsed after transplantation. The antigenemia assay and PCR stayed positive longer after institution of antiviral therapy than QSVC. PCR can provide highly sensitive detection of CMV viremia, but a PCR assay for CMV is not yet available in kit form. The pp65 antigenemia assay and shell vial culture are quantifiable and comparable in sensitivity. Either is recommended for rapid detection of CMV in blood specimens from solid-organ transplant recipients.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bailey T. C., Ettinger N. A., Storch G. A., Trulock E. P., Hanto D. W., Dunagan W. C., Jendrisak M. D., McCullough C. S., Kenzora J. L., Powderly W. G. Failure of high-dose oral acyclovir with or without immune globulin to prevent primary cytomegalovirus disease in recipients of solid organ transplants. Am J Med. 1993 Sep;95(3):273–278. doi: 10.1016/0002-9343(93)90279-x. [DOI] [PubMed] [Google Scholar]
- Boeckh M., Bowden R. A., Goodrich J. M., Pettinger M., Meyers J. D. Cytomegalovirus antigen detection in peripheral blood leukocytes after allogeneic marrow transplantation. Blood. 1992 Sep 1;80(5):1358–1364. [PubMed] [Google Scholar]
- Boland G. J., de Weger R. A., Tilanus M. G., Ververs C., Bosboom-Kalsbeek K., de Gast G. C. Detection of cytomegalovirus (CMV) in granulocytes by polymerase chain reaction compared with the CMV antigen test. J Clin Microbiol. 1992 Jul;30(7):1763–1767. doi: 10.1128/jcm.30.7.1763-1767.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brytting M., Xu W., Wahren B., Sundqvist V. A. Cytomegalovirus DNA detection in sera from patients with active cytomegalovirus infections. J Clin Microbiol. 1992 Aug;30(8):1937–1941. doi: 10.1128/jcm.30.8.1937-1941.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Buller R. S., Bailey T. C., Ettinger N. A., Keener M., Langlois T., Miller J. P., Storch G. A. Use of a modified shell vial technique to quantitate cytomegalovirus viremia in a population of solid-organ transplant recipients. J Clin Microbiol. 1992 Oct;30(10):2620–2624. doi: 10.1128/jcm.30.10.2620-2624.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cheeseman S. H., Rubin R. H., Stewart J. A., Tolkoff-Rubin N. E., Cosimi A. B., Cantell K., Gilbert J., Winkle S., Herrin J. T., Black P. H. Controlled clinical trial of prophylactic human-leukocyte interferon in renal transplantation. Effects on cytomegalovirus and herpes simplex virus infections. N Engl J Med. 1979 Jun 14;300(24):1345–1349. doi: 10.1056/NEJM197906143002401. [DOI] [PubMed] [Google Scholar]
- Delgado R., Lumbreras C., Alba C., Pedraza M. A., Otero J. R., Gómez R., Moreno E., Noriega A. R., Payá C. V. Low predictive value of polymerase chain reaction for diagnosis of cytomegalovirus disease in liver transplant recipients. J Clin Microbiol. 1992 Jul;30(7):1876–1878. doi: 10.1128/jcm.30.7.1876-1878.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dummer J. S., White L. T., Ho M., Griffith B. P., Hardesty R. L., Bahnson H. T. Morbidity of cytomegalovirus infection in recipients of heart or heart-lung transplants who received cyclosporine. J Infect Dis. 1985 Dec;152(6):1182–1191. doi: 10.1093/infdis/152.6.1182. [DOI] [PubMed] [Google Scholar]
- Einsele H., Steidle M., Vallbracht A., Saal J. G., Ehninger G., Müller C. A. Early occurrence of human cytomegalovirus infection after bone marrow transplantation as demonstrated by the polymerase chain reaction technique. Blood. 1991 Mar 1;77(5):1104–1110. [PubMed] [Google Scholar]
- Erice A., Holm M. A., Gill P. C., Henry S., Dirksen C. L., Dunn D. L., Hillam R. P., Balfour H. H., Jr Cytomegalovirus (CMV) antigenemia assay is more sensitive than shell vial cultures for rapid detection of CMV in polymorphonuclear blood leukocytes. J Clin Microbiol. 1992 Nov;30(11):2822–2825. doi: 10.1128/jcm.30.11.2822-2825.1992. [DOI] [PMC free article] [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. Rapid detection of cytomegalovirus in MRC-5 cells inoculated with urine specimens by using low-speed centrifugation and monoclonal antibody to an early antigen. J Clin Microbiol. 1984 Jun;19(6):917–919. doi: 10.1128/jcm.19.6.917-919.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goodrich J. M., Mori M., Gleaves C. A., Du Mond C., Cays M., Ebeling D. F., Buhles W. C., DeArmond B., Meyers J. D. Early treatment with ganciclovir to prevent cytomegalovirus disease after allogeneic bone marrow transplantation. N Engl J Med. 1991 Dec 5;325(23):1601–1607. doi: 10.1056/NEJM199112053252303. [DOI] [PubMed] [Google Scholar]
- Jiwa N. M., Van Gemert G. W., Raap A. K., Van de Rijke F. M., Mulder A., Lens P. F., Salimans M. M., Zwaan F. E., Van Dorp W., Van der Ploeg M. Rapid detection of human cytomegalovirus DNA in peripheral blood leukocytes of viremic transplant recipients by the polymerase chain reaction. Transplantation. 1989 Jul;48(1):72–76. doi: 10.1097/00007890-198907000-00017. [DOI] [PubMed] [Google Scholar]
- Kwok S., Higuchi R. Avoiding false positives with PCR. Nature. 1989 May 18;339(6221):237–238. doi: 10.1038/339237a0. [DOI] [PubMed] [Google Scholar]
- Marsano L., Perrillo R. P., Flye M. W., Hanto D. W., Spitzer E. D., Thomas J. R., Murray P. R., Windus D. W., Brunt E. M., Storch G. A. Comparison of culture and serology for the diagnosis of cytomegalovirus infection in kidney and liver transplant recipients. J Infect Dis. 1990 Mar;161(3):454–461. doi: 10.1093/infdis/161.3.454. [DOI] [PubMed] [Google Scholar]
- Rowley A. H., Wolinsky S. M., Sambol S. P., Barkholt L., Ehrnst A., Andersson J. P. Rapid detection of cytomegalovirus DNA and RNA in blood of renal transplant patients by in vitro enzymatic amplification. Transplantation. 1991 May;51(5):1028–1033. doi: 10.1097/00007890-199105000-00019. [DOI] [PubMed] [Google Scholar]
- Schmidt G. M., Horak D. A., Niland J. C., Duncan S. R., Forman S. J., Zaia J. A. A randomized, controlled trial of prophylactic ganciclovir for cytomegalovirus pulmonary infection in recipients of allogeneic bone marrow transplants; The City of Hope-Stanford-Syntex CMV Study Group. N Engl J Med. 1991 Apr 11;324(15):1005–1011. doi: 10.1056/NEJM199104113241501. [DOI] [PubMed] [Google Scholar]
- Shibata D., Martin W. J., Appleman M. D., Causey D. M., Leedom J. M., Arnheim N. Detection of cytomegalovirus DNA in peripheral blood of patients infected with human immunodeficiency virus. J Infect Dis. 1988 Dec;158(6):1185–1192. doi: 10.1093/infdis/158.6.1185. [DOI] [PubMed] [Google Scholar]
- Shuster E. A., Beneke J. S., Tegtmeier G. E., Pearson G. R., Gleaves C. A., Wold A. D., Smith T. F. Monoclonal antibody for rapid laboratory detection of cytomegalovirus infections: characterization and diagnostic application. Mayo Clin Proc. 1985 Sep;60(9):577–585. doi: 10.1016/s0025-6196(12)60979-3. [DOI] [PubMed] [Google Scholar]
- Spector S. A., Merrill R., Wolf D., Dankner W. M. Detection of human cytomegalovirus in plasma of AIDS patients during acute visceral disease by DNA amplification. J Clin Microbiol. 1992 Sep;30(9):2359–2365. doi: 10.1128/jcm.30.9.2359-2365.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- The T. H., van der Ploeg M., van den Berg A. P., Vlieger A. M., van der Giessen M., van Son W. J. Direct detection of cytomegalovirus in peripheral blood leukocytes--a review of the antigenemia assay and polymerase chain reaction. Transplantation. 1992 Aug;54(2):193–198. doi: 10.1097/00007890-199208000-00001. [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]
- van der Bij W., Schirm J., Torensma R., van Son W. J., Tegzess A. M., The T. H. Comparison between viremia and antigenemia for detection of cytomegalovirus in blood. J Clin Microbiol. 1988 Dec;26(12):2531–2535. doi: 10.1128/jcm.26.12.2531-2535.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]