Detection of antibody to cytomegalovirus-induced early antigens and comparison with four serologic assays and presence of viruria in blood donors

Abstract

Five hundred blood donors were evaluated for cytomegalovirus (CMV) viruria, antibody to CMV early antigens (EA-ab), CMV seropositivity by two screening assays, and CMV-specific immunoglobulin M by two methods. Three donors were viruric, EA-ab positive, and seropositive; two viruric donors were immunoglobulin M positive.

The Incidence and Consequences of Cytomegalovirus Transmission via Blood Transfusion to Low Birth Weight, Premature Infants in North East Scotland

“…None of the seropositive infants, however, developed a 4-fold increase in titre following blood transfusion unless they were genuinely infected. We have not been able to confirm the findings of others [8, 91that CMV-specific IgM in donor blood is related to infectivityand conclude, as other studies have [27], that there is no association. It is important to note that both former studies used an IF assay to measure the antibody.…”

Early serodiagnosis of acute human cytomegalovirus infection by enzyme-linked immunosorbent assay using recombinant antigens

“…Forty percent of sera from healthy blood donors without any evidence of acute HCMV infection reacted with this antigen. In comparison, IgM-specific prevalence as determined with different IgM ELISAs in comparable populations normally ranges from 1 to 13% (2,9,20). Therefore, the high level of reactivity of 150/1 in the recombinant ELISA must be considered, at least in part, false positive.…”

Acquisition of cytomegalovirus infection: an update.

“…However, in some instances, IgM is not detectable during reinfection with CMV and its measurement can be complicated by false-positive tests (57,154). On the basis of a number of studies, the presence of CMV antibody to IE and E antigens may serve as an even better means of identifying infectious blood donors with active virus replication than CMV IgM (86,95). The presence of high levels of anti-CMV E antibodies appears to reflect recent or active virus replication in the host, and the level of IgG to E antigens declines after virus excretion ceases (95).…”

“…The presence of high levels of anti-CMV E antibodies appears to reflect recent or active virus replication in the host, and the level of IgG to E antigens declines after virus excretion ceases (95). More recently, Lentz et al (86) found that CMV-specific IgM was not consistently present in their viruric donors, but IgG antibody to E antigens correlated with viruria. In summary, direct evidence in support of an actively infected subset of infectious blood donors as a mechanism for the transmission of CMV infection has been difficult to obtain.…”

“…Other approaches to prevent TA-CMV infection have involved methods to decrease the potential infectivity of seropositive units by either freezing erythrocytes (150) or extending the shelf life to provide less fresh donor blood (151); however, these methods are costly and not always appropriate. Since only a subset of seropositive donors transmit CMV infection to the recipients of their blood, studies have approached the prevention of TA-CMV disease by examining other serological markers which might better identify the infectious units of CMV-serpositive blood (2,18,32,82,86); additional studies are needed to validate the efficacy of screening donor blood for CMV IgM or possibly to early antibodies. Providing saline-washed erythrocytes or irradiated blood components has failed to prevent CMV transmission (22,30).…”