title: Comparison of the performance of polymerase chain reaction and pp65 antigenemia for the detection of human cytomegalovirus in immunosuppressed patients.
abstract: BACKGROUND
  Human cytomegalovirus (HCMV) is often reactive in latently infected immunosuppressed patients. Accordingly, HCMV remains one of the most common infections following solid organ and hemopoietic stem cell transplantations, resulting in significant morbidity, graft loss and occasional mortality. The early diagnosis of HCMV disease is important in immunosuppressed patients, since in these individuals, preemptive treatment is useful. The objective of this study was to compare the performance of the in-house qualitative polymerase chain reaction (PCR) and pp65 antigenemia to HCMV infection in immunosuppressed patients in the Hospital de Clínicas of Porto Alegre (HCPA).
  
  
  METHODS
  A total of 216 blood samples collected between August 2006 and January 2007 were investigated.
  
  
  RESULTS
  Among the samples analyzed, 81 (37.5%) were HCMV-positive by PCR, while 48 (22.2%) were positive for antigenemia. Considering antigenemia as the gold standard, sensitivity, specificity, positive predictive values and negative predictive values for PCR were 87.5%, 76.8%, 51.8% and 95.5% respectively.
  
  
  CONCLUSIONS
  These results demonstrated that qualitative PCR has high sensitivity and negative predictive value (NPV). Consequently PCR is especially indicated for the initial diagnosis of HCMV infection. In the case of preemptive treatment strategy, identification of patients at high-risk for HCMV disease is fundamental and PCR can be useful tool.
authors.affiliation: Unidade de Microbiologia e Biologia Molecular, Serviço de Patologia Clínica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Patrícia Borba
authors.initials: PB
authors.lastname: Martiny
authors.forename: Fernanda
authors.initials: F
authors.lastname: de-Paris
authors.forename: Alice Beatriz Mombach Pinheiro
authors.initials: AB
authors.lastname: Machado
authors.forename: Ricardo Obalski de
authors.initials: RO
authors.lastname: Mello
authors.forename: Martha Bergman
authors.initials: MB
authors.lastname: Senger
authors.forename: Maria Clara Medina
authors.initials: MC
authors.lastname: Corrêa
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Werres Junior
authors.forename: Carolina Fischinger Moura
authors.initials: CF
authors.lastname: de Souza
mesh_terms: D000956:Antigens, Viral / Q000032:analysis*; D003587:Cytomegalovirus / Q000235:genetics* / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000276:immunology; D004279:DNA, Viral / Q000032:analysis*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D010750:Phosphoproteins / Q000276:immunology; D016133:Polymerase Chain Reaction / Q000379:methods; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014763:Viral Matrix Proteins / Q000276:immunology
chemical_list: D000956:Antigens, Viral; D004279:DNA, Viral; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa