New molecular assays to predict occurrence of cytomegalovirus disease in renal transplant recipients.
Thirty renal transplant recipients, after transplantation, were tested weekly with the following assays: cytomegalovirus (CMV) antigenemia (pp65 Ag), plasma qualitative Amplicor CMV (P-AMP), plasma and peripheral blood leukocyte quantitative Amplicor CMV monitor (P- and PBL-CMM), peripheral blood leukocyte (PBL) quantitative Quantiplex bDNA CMV, version 2.0 (bDNA), and whole-blood Nuclisens pp67 CMV (pp67). Eleven patients developed symptomatic CMV disease, and 7 developed asymptomatic CMV infection. For prediction of CMV disease, the sensitivity, specificity, and positive and negative predictive values, respectively, were as follows: 100%, 63%, 61%, and 100% for pp65 Ag; 100%, 42%, 50%, and 100% for bDNA; 91%, 47%, 50%, and 90% for PBL-CMM; 55%, 74%, 55%, and 74% for P-AMP; 55%, 74%, 55%, and 74% for P-CMM; and 64%, 79%, 64%, and 79% for pp67. First positive results in PBL were obtained 9-10 days before symptoms of CMV disease, compared with 5-6 days in plasma and 0 days in whole blood. PBL assays appear to be more appropriate than plasma assays when pre-emptive therapy is required to prevent the rapid progression from the first detection of the virus to CMV disease.
Pellegrin
I
I
Laboratoire de Virologie, Centre Hospitalier Régional Hôpital Pellegrin, place Amélie-Raba-Léon, 33 076 Bordeaux Cédex, France. isabelle.pellegrin@chu-bordeaux.fr
Garrigue
I
I
Ekouevi
D
D
Couzi
L
L
Merville
P
P
Merel
P
P
Chene
G
G
Schrive
M H
MH
Trimoulet
P
P
Lafon
M E
ME
Fleury
H
H
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification / Q000378:metabolism; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D010750:Phosphoproteins / Q000032:analysis*; D012680:Sensitivity and Specificity; D014763:Viral Matrix Proteins / Q000032:analysis*
D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa