Qualitative detection of human cytomegalovirus DNA in the plasma of bone marrow transplant recipients: value as a predictor of disease progression.
OBJECTIVE
The aim of this prospective study was to determine whether human cytomegalovirus (HCMV)-DNA detected by polymerase chain reaction (PCR) analysis in the plasma of bone marrow transplant (BMT) patients is a predictor of HCMV disease progression.


METHODS
Plasma samples were collected from 15 patients who received allogenic BMTs. Each individual was sampled 1 week before and then weekly for 17 weeks after transplantation. The 270 plasma specimens were processed with a PCR method for detecting HCMV-DNA. Patients were also physically examined for signs or symptoms of HCMV-related disease.


RESULTS
Eight (53.5%) of the 15 patients tested positive for HCMV-DNA. Two (25%) of these 8 individuals also had positive PCR findings before transplantation. Six (75%) of the 8 HCMV-DNA-positive patients had positive plasma-PCR results a week before clinical symptoms developed. The other 2 (25%) remained asymptomatic throughout their hospital stay. All 6 symptomatic cases were treated with ganciclovir, and 4 converted to negative plasma-PCR status at a median of 21 days. There was a significant correlation between PCR-detection of HCMVDNA in plasma and presence of HCMV-related symptoms (P < 0.01).


CONCLUSIONS
Qualitative plasma-PCR analysis before and after bone marrow transplantation is a valuable way to screen for HCMV infection in BMT patients. Plasma-PCR monitoring of HCMV activity in this patient group might make it possible to administer an antiviral drug and thus reduce mortality. However, quantitative PCR is still considered the best way to accurately identify active HCMV infection and monitor treatment.
Behzad-Behbahani
A
A
Clinical Virology Section, Organ Transplant Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. Behbahani_2000@yahoo.com
Ehsanipour
F
F
Alborzi
A
A
Nourani
H
H
Ramzi
M
M
Rasoli
M
M
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000209:etiology / Q000503:physiopathology* / Q000821:virology*; D004279:DNA, Viral / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
D004279:DNA, Viral