Analysis of cytomegalovirus (CMV) viremia using the pp65 antigenemia assay, the amplicor CMV test, and a semi-quantitative polymerase chain reaction test after allogeneic marrow transplantation.
A pp65 antigenemia assay for polymorphonuclear leukocytes (PMNLs) (CINAkit Rapid Antigenemia), and a qualitative polymerase chain reaction (PCR) test for plasma 'PCR-P qual' (Amplicor cytomegalovirus [CMV] test) were performed for 126 samples (blood and plasma) obtained from 18 bone marrow transplant patients, over a 9-month surveillance period. Among those samples, 92 were assayed with a semi-quantitative PCR test for PMNLs 'PCR-L quant.' The number of samples with a positive CMV test for antigenemia and PCR-P qual assays was 20.63% and 12.7%, respectively, whereas the PCR-L quant assay was positive in 48 of the 92 samples assayed (52.17%). The rates of concordance of the results of PCR-P qual and antigenemia, PCR-P qual and PCR-L quant, antigenemia and PCR-L quant were 92%, 65.2% and 66.8%, respectively. The analysis of the results for the 92 specimens tested by all 3 methods showed a rate of concordance of 63% among all methods. Good agreement (kappa=0.72) was found only between pp65 Ag and PCR-P qual assays. Clinical disease correlates with an antigenemia high viral load. Three patients had CMV disease despite preemptive therapy, and all of them had graft-versus-host-disease (GVHD). PMNLs-based assays are more efficient in monitoring CMV reactivation, but for high-risk patients with GVHD, more sensitive assays (real-time PCR) must be done.
Ksouri
H
H
Service des Laboratoires, Centre National de Greffe de Moelle Osseuse, Tunis, Tunisia. ksourih_2000@yahoo.fr
Eljed
H
H
Greco
A
A
Lakhal
A
A
Torjman
L
L
Abdelkefi
A
A
Ben Othmen
T
T
Ladeb
S
S
Slim
A
A
Zouari
B
B
Abdeladhim
A
A
Ben Hassen
A
A
D000293:Adolescent; D000328:Adult; D000956:Antigens, Viral / Q000097:blood; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D003587:Cytomegalovirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006098:Granulocytes / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010750:Phosphoproteins / Q000097:blood*; D016133:Polymerase Chain Reaction; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D019172:Transplantation Conditioning / Q000009:adverse effects; D019562:Viral Load; D014763:Viral Matrix Proteins / Q000097:blood*; D014766:Viremia / Q000097:blood / Q000175:diagnosis
D000956:Antigens, Viral; D004279:DNA, Viral; D010750:Phosphoproteins; D011933:Reagent Kits, Diagnostic; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa