title: Methodology for monitoring cytomegalovirus infection after renal transplantation.
abstract: BACKGROUND
  The aim of this study was to evaluate the diagnostic value of different detection methods for cytomegalovirus (CMV) infection after renal transplantation and also to establish a system to monitor therapy for CMV infection.
  
  
  METHODS
  We retrospectively studied 1516 renal transplant recipients from June 1994 to December 2006. All patients were screened for CMV-DNA. A total of 1402 patients had received CMV-IgG/IgM detection since June 1996 and 660 had received CMV antigen detection since June 2000.
  
  
  RESULTS
  A total of 664 (43.8%) recipients developed CMV infection. The sensitivity, specificity and Youden index of the three methods, respectively, were 18.84%, 100% and 0.1884 for ELISA, 91.86%, 82.98% and 0.7484 for PCR, and 88.06%, 96.95% and 0.8501 for the CMV-pp65 antigenemia test. The sensitivity and specificity of the two combined detection methods (CMV-DNA and CMV-pp65) for post-operation CMV infection were 93.49% and 99.06%; the two detection methods had significant dependability (p<0.05) in diagnosis of CMV infection and in evaluation of therapeutic effect of antiviral drugs.
  
  
  CONCLUSIONS
  Only ELISA can be used as a screening index in order to distinguish whether the donors or recipients are infected with CMV or not. CMV-pp65 antigenemia can help guide clinical therapy for CMV infection. CMV-pp65 and CMV-PCR combined together provide a more effective method to monitor CMV infection and predict its outcome.
authors.affiliation: Department of Renal Transplantation, the First Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, China. xuewj2008@gmail.com
authors.forename: Wujun
authors.initials: W
authors.lastname: Xue
authors.forename: Hua
authors.initials: H
authors.lastname: Liu
authors.forename: Hang
authors.initials: H
authors.lastname: Yan
authors.forename: Puxun
authors.initials: P
authors.lastname: Tian
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Ding
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Pan
authors.forename: Xinshun
authors.initials: X
authors.lastname: Feng
authors.forename: Heli
authors.initials: H
authors.lastname: Xiang
authors.forename: Jun
authors.initials: J
authors.lastname: Hou
authors.forename: Xiaoli
authors.initials: X
authors.lastname: He
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000998:Antiviral Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M