Cytomegalovirus testing: Antibody determinations and virus cultures with recommendations for use

Abstract

Human cytomegalovirus is a ubiquitous virus with the property of becoming latent in the immunocompetent host. It can also cause devastating infections in the immunocompromised patient. Several different assays are available to detect either cytomegalovirus antibodies or cytomegalovirus itself, five of which are used at the University of Wisconsin Hospitals and Clinics and the Wisconsin State Laboratory of Hygiene. The latex agglutination (LA) test is used to detect antibody positivity in transplant donors, transplant recipients, and others. The complement fixation (CF) test is used to detect seroconversion or reactivation of infection in the CMV positive host. The immunofluorescent antibody-IgM (IFA-IgM) test is used to diagnose infection in congenitally or neonatally infected infants. The "routine" CMV culture is the "gold standard" for the detection of the cytomegalovirus in patient secretions. The shell vial assay, a rapid method of detecting virus, is most useful when contemplating therapy for active CMV infection. The advantages and limitations, as well as the timing and appropriateness of each test, are reviewed.

NK and CD8+ T cell phenotypes predict onset and control of CMV viremia after kidney transplant

“…CMV infection in immunocompetent individuals is mostly asymptomatic ( 1 ), but the virus is controlled rather than cleared, leading to lifelong persistence ( 2 ). Infection induces humoral immunity and circulating anti-CMV antibodies are used to define prior exposure ( 3 ); however, the protective role of these antibodies is unclear. Conversely, NK and T cells, particularly CD8 + T cells, are critical for control of primary infection and reactivation ( 4 , 5 ).…”

Pitfalls in the Serological Evaluation of Maternal Cytomegalovirus Infection as a Potential Cause of Fetal and Neonatal Involvements: A Narrative Literature Review

“…Following an initial CMV infection, the host begins to produce IgG antibodies to the virus within 1–2 weeks, and the production of CMV-specific IgG antibodies continues lifelong [ 22 ]. The most straightforward confirmation of primary CMV infection is determined based on findings of CMV-IgG seroconversion (i.e., conversion from negative to positive CMV-IgG antibody test findings).…”

Cytomegalovirus seroprevalence, recurrence, and antibody levels

“…Following the initial infection, the host begins to produce immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies specific to the virus within 1–2 weeks. 23 The production of CMV-specific IgG will continue for life, thus, their presence in sera serves only as an indicator of past exposure to the virus. In contrast, the production of CMV IgM tends to halt 3–6 months after the primary infection but can restart when reinfected by a different viral strain or when latent infections are reactivated.…”