title: Use of the cytomegalovirus antigenemia (CMV-Ag) assay for the detection of CMV in the blood of AIDS patients.
abstract: Direct specimen testing was performed on 186 peripheral blood specimens to identify the presence of antigen to cytomegalovirus (viz., the cytomegalovirus antigenemia (CMV-Ag) assay). Confirmatory testing was performed using the shell vial indirect immunofluorescence assay (SVA-IFA), the indirect immunoperoxidase assay (TC-IPA), and conventional tube culture isolation (TC-CPE). The primary reagent for the CMV-Ag assay consisted of anti-CMV monoclonal antibody directed against the internal matrix structural phosphoprotein (1C3; Clonatec-Biosoft, France). The 72-kDa early nuclear antigen (Dupont) was utilized in the SVA-IFA and the TC-IPA. All test systems received an equal number of polymorphonuclear leukocytes in the inoculum. CMV was detected and isolated from 30% (55/186) of the specimens evaluated by either one or a combination of the tests. Detection and (or) isolation of CMV from blood by the CMV-Ag assay, SV-IFA, TC-IPA, and TC-CPE occurred at a rate of 17 (31/186), 12 (22/186), 16 (29/186), and 26% (49/186). Three of 55 positive specimens were identified only by the CMV-Ag assay; each patient in question, however, had at least one previous CMV isolate. No significant differences in sensitivity occurred between the CMV-Ag assay, the SVA-IFA, or the TC-IPA. However, TC-CPE including the blind passage of all negative tube cultures yielded a significantly larger number of positive blood specimens than either of the rapid detection methodologies. The CMV-Ag assay encompasses the benefits of a nonculture system, is simple to perform and easy to read, permits a same-day diagnosis, and requires less reagents than the routinely used SVA-IFA or TC-IPA.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Jane and Dayton Brown and Dayton T. Brown, Jr., Virology Laboratory, Department of Medicine, North Shore University Hospital-Cornell University Medical College, Manhasset, NY 11030.
authors.forename: S M
authors.initials: SM
authors.lastname: Lipson
authors.forename: M H
authors.initials: MH
authors.lastname: Kaplan
authors.forename: L F
authors.initials: LF
authors.lastname: Tseng
authors.forename: F S
authors.initials: FS
authors.lastname: Mandel
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000956:Antigens, Viral / Q000097:blood*; D001769:Blood / Q000382:microbiology; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D012698:Serologic Tests / Q000379:methods*
chemical_list: D000956:Antigens, Viral