Evaluation of the murex hybrid capture cytomegalovirus DNA assay versus plasma PCR and shell vial assay for diagnosis of human cytomegalovirus viremia in immunocompromised patients.
We evaluated a cytomegalovirus (CMV) 24-hour shell vial assay (SVA), the Murex Hybrid Capture CMV DNA assay (HCA), and a CMV plasma PCR for the detection of CMV viremia in renal and bone marrow transplant recipients and human immunodeficiency virus-infected patients. CMV viremia was detected by at least one method in 125 of 317 evaluable samples (39.4%) from 78 patients and was detected in 19.8% of samples by SVA, 26.8% by HCA, and 32.2% by plasma PCR. There was moderate to substantial agreement between the results of the different tests (kappa coefficient = 0.415 to 0.631). However, HCA and plasma PCR were significantly more sensitive than SVA (P = 0.001 and P < 0.0001, respectively; McNemar's test), and plasma PCR was more sensitive than HCA (P = 0.031; McNemar's test). HCA and plasma PCR were more consistently positive than SVA during viremic episodes (P = 0.0002 and P < 0.0001, respectively; McNemar's test). The use of HCA or plasma PCR may therefore improve the diagnosis and management of CMV disease in susceptible patient groups.
Barrett-Muir
W Y
WY
Department of Clinical Virology, Royal Hospitals NHS Trust, London, United Kingdom. W.Y.Barrett-Muir@mds.qmw.ac.uk
Aitken
C
C
Templeton
K
K
Raftery
M
M
Kelsey
S M
SM
Breuer
J
J
D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000175:diagnosis / Q000821:virology; D016026:Bone Marrow Transplantation; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis*; D004279:DNA, Viral / Q000097:blood; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D009693:Nucleic Acid Hybridization / Q000379:methods; D016133:Polymerase Chain Reaction / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012698:Serologic Tests; D014766:Viremia / Q000097:blood / Q000175:diagnosis*
D004279:DNA, Viral