[Early diagnosis of cytomegalovirus infections in organ recipients].
BACKGROUND
Cytomegalovirus (CMV) infections and acute rejection of organs are the commonest complications in the early posttransplantation period. Clinical picture of CMV reactivation in organ recipients may have a dramatic course, occasionally even with a fatal outcome.
In order to prevent acute rejection of organs in the posttransplantation period, patients are subjected to immunosuppressive therapy, which sustains reactivation of CMV. Thus, early diagnosis of CMV infections before clinical assay of CMV, is of crucial importance. Early diagnosis allows preventive antiviral therapy. Conventional and contemporary diagnostic tests are presented, with particular review on their interpretation and significance in prevention of CMV infections. Present serologic tests are positive a few weeks after infection, which is late for organ recipients. Cytopathogenic effects characteristic for CMV occur several weeks later. Antigenemia assay is a fast, quantitative test for detection of early CMV antigen pp65. Methods of molecular biology represent the latest innovation in the laboratory diagnosis of posttransplantation CMV infections. However, they have been in use only lately, and therefore their use and significance are still not sufficiently experienced. Standardization is thus required, in order to provide comparison between various diagnostic centres.
Drasković
Nada
N
Institut za mikrobiologiju, Odeljenje za virusologiju, Vojnomedicinska akademija, Beograd.
Jovanović
Dragutin
D
Kuljić-Kapulica
Nada
N
D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000209:etiology; D016377:Organ Transplantation / Q000009:adverse effects*