Cytomegalovirus frequency in neonatal intrahepatic cholestasis determined by serology, histology, immunohistochemistry and PCR.
OBJECTIVE
To determine cytomegalovirus (CMV) frequency in neonatal intrahepatic cholestasis by serology, histological revision (searching for cytomegalic cells), immunohistochemistry, and polymerase chain reaction (PCR), and to verify the relationships among these methods.


METHODS
The study comprised 101 non-consecutive infants submitted for hepatic biopsy between March 1982 and December 2005. Serological results were obtained from the patient's files and the other methods were performed on paraffin-embedded liver samples from hepatic biopsies. The following statistical measures were calculated: frequency, sensibility, specific positive predictive value, negative predictive value, and accuracy.


RESULTS
The frequencies of positive results were as follows: serology, 7/64 (11%); histological revision, 0/84; immunohistochemistry, 1/44 (2%), and PCR, 6/77 (8%). Only one patient had positive immunohistochemical findings and a positive PCR. The following statistical measures were calculated between PCR and serology: sensitivity, 33.3%; specificity, 88.89%; positive predictive value, 28.57%; negative predictive value, 90.91%; and accuracy, 82.35%.


CONCLUSIONS
The frequency of positive CMV varied among the tests. Serology presented the highest positive frequency. When compared to PCR, the sensitivity and positive predictive value of serology were low.
Bellomo-Brandao
Maria Angela
MA
Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, São Paulo 13083-060, Brazil. bellomobrandao@globo.com
Andrade
Paula D
PD
Costa
Sandra C B
SC
Escanhoela
Cecilia A F
CA
Vassallo
Jose
J
Porta
Gilda
G
De Tommaso
Adriana M A
AM
Hessel
Gabriel
G
D002780:Cholestasis, Intrahepatic / Q000097:blood* / Q000473:pathology / Q000821:virology*; D003587:Cytomegalovirus / Q000235:genetics / Q000378:metabolism; D003586:Cytomegalovirus Infections / Q000097:blood / Q000453:epidemiology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000737:chemistry / Q000821:virology; D008297:Male; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D012698:Serologic Tests; D019562:Viral Load