Table 1.
Characteristics, costs, and problems of diagnostic tests for the detection of CMV (modified, based on Kandiel and Lashner [57])
| Test | Test material | Sensitivity, % | Specificity, % | Cost | Problem |
|---|---|---|---|---|---|
| Histology (H&E) | Biopsy | 10–87 | 92–100 | $ | Sampling error |
| Histology (IHC) | Biopsy | 78–93 | 92–100 | $$ | Sampling error |
| CMV culture | Blood, tissue, urine, saliva, or respiratory swabs | 45–78 | 89–100 | $$ | 1–3 weeks incubation time |
| CMV-DNA PCR | Plasma, stool, biopsy | 65–100 | 40–92 | $$$ | Qualitative PCR: differentiating between CMV infection and disease is difficult |
| Quantitative PCR: no standardized technique, cutoff not defined | |||||
| CMV IgM (serum) | Blood | 100 | 99 | $$ | May not be present in immunocompromised patients |
| CMV IgG (serum) | Blood | 98–100 | 96–99 | $$ | Fourfold increase between two separate titers |
| CMV antigen | Blood, cerebrospinal fluid | 60–100 | 83–100 | $ | Semiquantitative |
H&E = Hematoxylin and eosin stain.