title: Monitoring human cytomegalovirus infection in pediatric hematopoietic stem cell transplant recipients: using an affordable in-house qPCR assay for management of HCMV infection under limited resources.
abstract: Quantitative real-time PCR (qPCR) assay is accepted as the method of choice for monitoring human cytomegalovirus (HCMV) infection in hematopoietic stem cell transplant recipients, but the high cost of commercial kits has hampered its use in many developing countries. In this study, an affordable in-house qPCR was used to manage HCMV infection in pediatric patients and the diagnostic value of this method was compared with the conventional pp65 antigenemia assay. A total number of 1179 samples from 82 recipients were used in this study, and the effect of some potential risk factors on HCMV reactivation was evaluated. The qPCR was able to detect HCMV reactivation earlier and with higher sensitivity than antigenemia assay. Forty-six episodes of reactivation were detected in 39 patients, of which all were detected by the qPCR assay, while only 21 episodes were diagnosed by antigenemia. The DNAemia level of 1284 IU/ml plasma was defined as the optimal cutoff value for starting pre-emptive therapy. It was shown that the acute GVHD severity and the relationship of donor and recipient are the most significant risk factors for HCMV reactivation. The data suggest that the antigenemia method for monitoring HCMV reactivation could be substituted by the qPCR assay.
authors.affiliation: Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran; Department of Microbiology and Immunology, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Khansarinejad
authors.forename: Hoorieh
authors.initials: H
authors.lastname: Soleimanjahi
authors.forename: Siamak
authors.initials: S
authors.lastname: Mirab Samiee
authors.forename: Amir Ali
authors.initials: AA
authors.lastname: Hamidieh
authors.forename: Mahdi
authors.initials: M
authors.lastname: Paryan
authors.forename: Yadollah
authors.initials: Y
authors.lastname: Sanahmadi
authors.forename: Manoochehr
authors.initials: M
authors.lastname: Karami
authors.forename: Mahdieh
authors.initials: M
authors.lastname: Mondanizadeh
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D004279:DNA, Viral / Q000097:blood / Q000737:chemistry; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008297:Male; D010750:Phosphoproteins / Q000097:blood; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction / Q000191:economics*; D012307:Risk Factors; D014184:Transplantation, Homologous; D014763:Viral Matrix Proteins / Q000097:blood
chemical_list: D004279:DNA, Viral; D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa
keywords: antigenemia; cytomegalovirus; pediatric; pp65; qPCR; transplantation