Detection of human cytomegalovirus in renal transplantation: Comparison of four diagnostic methods: DNA in sera by polymerase chain reaction (PCR), DNA in leukocyte by PCR, pp65 leukocytic antigenemia, and viremia

Eckart, P.; Brouard, J.; Vabret, Astrid; Freymuth, F.; Guillot, Monique; Ryckelynck, J. P.; Ligny, Bruno Hurault de

doi:10.1016/s0041-1345(97)00414-4

Cited by 13 publications

(15 citation statements)

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“…The sensitivity of the leukocyte assays in this study is consistent with previous findings reported in Tong et al (1998), Eckart et al (1997, Rollag et al (1998), Schäfer et al (1998. CMV DNA in leukocytes may appear earlier and persist longer than CMV DNA in plasma.…”

Section: Discussionsupporting

confidence: 93%

“…Studies concerning the sensitivity of leukocyte PCRs demonstrate their convenience as they are positive 8 to 13 days before the onset of illness on average (Tong et al 1998(Tong et al , 2000. According to Eckart et al (1997) DNA in leukocytes is the earliest diagnostic method and appears 22 days before clinical symptoms. Moreover the detection of CMV DNA in polymorphonuclear leukocytes is associated with active infections and is more sensitive than detection of CMV DNA in plasma as shown in a study by Schäfer et al (1998).…”

Section: Discussionmentioning

confidence: 99%

“…The early identification of CMV is important as the majority of patients develop infection and the best result is obtained when treatment is started earlier (Rubin & Tolkoff-Rubin 1993). CMV must be detected before clinical symptom appearance, but virus detection is not always followed by CMV disease (Eckart et al 1997). Laboratory diagnosis of CMV infection is based primarily on the detection of CMV viremia and active CMV infection after the onset of symptoms.…”

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confidence: 99%

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A follow up study of cytomegalovirus infection in a group of Turkish renal transplant recipients using molecular assays

Çırak

Rota

Maral

et al. 2005

Mem. Inst. Oswaldo Cruz

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The clinical value of an in-house cytomegalovirus nested polymerase chain reaction (CMV-PCR) and a commercial molecular assay hybrid capture CMV DNA assay (HCA) was evaluated in monitoring a group of renal transplant patients for six months follow up. In this study, the sensitivity, specificity, positive predictive value, and negative predictive value of nested CMV DNA PCR assay and HCA at the beginning of the study were 70, 42.9, 46.7, 66.7, and 60, 78.6, 66.7, and 73.3% respectively. After six months, they were 80, 66.7, 80, 66.7 for CMV PCR and 73.3, 88.9, 91.7, 66.7% Human cytomegalovirus (CMV) infection is responsible for significant mortality and morbidity and graft failure in renal transplant recipients (Tong et al. 1998). The early identification of CMV is important as the majority of patients develop infection and the best result is obtained when treatment is started earlier (Rubin & Tolkoff-Rubin 1993). CMV must be detected before clinical symptom appearance, but virus detection is not always followed by CMV disease (Eckart et al. 1997). Laboratory diagnosis of CMV infection is based primarily on the detection of CMV viremia and active CMV infection after the onset of symptoms. By means of advanced laboratory assays, it is possible to have positive laboratory assay results before the onset of symptoms. However, laboratory diagnosis of active CMV infection is not always associated with symptomatic disease (Tong et al. 1998) and the identification of these patients for clinically relevant disease is difficult.Various qualitative and quantitative molecular assays are used to monitor renal transplant recipients and they appear to be more convenient and sensitive than the traditional methods such as serology, virus cultures and shell vial assays. The detection CMV DNA in leukocytes or plasma by polymerase chain reaction (PCR) is the most sensitive method of identifying CMV disease. However a highly sensitive CMV-PCR may detect latent virus that is not involved in disease (Rollag et al. 1998). The commonly used DNA hybridization assays offer the advantage of objective CMV DNA detection and quantification without the hazards of PCR such as contamination or inhibition (Aitken et al. 1999). The aim of this study was to monitor a group of adult Turkish renal transplant patients for six months follow up by using PCR and hybrid capture CMV DNA assay (HCA) in detecting and predicting CMV disease and to evaluate the relationship between the CMV-DNA presence and the symptomatic human CMV infection. As far as we are concerned this is the first follow up study in renal transplant patients using molecular assays in Turkey. MATERIALS AND METHODSPatients and specimens -Blood samples were obtained from 24 kidney transplant recipients who were CMV IgG positive. EDTA-anticoagulated blood samples were collected at monthly intervals during six months. All of the blood samples were evaluated with both PCR and HCA at the beginning of this follow up study and after six months. In the same way, the clinical symptoms of the pat...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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A follow up study of cytomegalovirus infection in a group of Turkish renal transplant recipients using molecular assays

Çırak

Rota

Maral

et al. 2005

Mem. Inst. Oswaldo Cruz

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“…There have been several studies showing a correlation between CMV infection and the viral load present in cell-free serum (132,133) or plasma (80,99,126,134). The source of CMV in plasma samples may be lysis of infected leukocytes or release from other infected sites, such as parenchymal and endothelial cells.…”

Section: Nucleic Acid-based Methodsmentioning

confidence: 99%

“…Since CMV in plasma or serum may be due primarily to release from actively infected cells, it has been suggested that the detection of CMV in these samples is more specific for CMV infection than its detection in whole blood or peripheral blood leukocytes (whose CMV levels may be due to cell-associated latent CMV). Indeed, studies have demonstrated that detection of CMV DNA in plasma is highly associated with CMV disease (132,133,135).…”

Section: Nucleic Acid-based Methodsmentioning

confidence: 99%

Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

2013

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SUMMARY The negative impact of cytomegalovirus (CMV) infection on transplant outcomes warrants efforts toward improving its prevention, diagnosis, and treatment. During the last 2 decades, significant breakthroughs in diagnostic virology have facilitated remarkable improvements in CMV disease management. During this period, CMV nucleic acid amplification testing (NAT) evolved to become one of the most commonly performed tests in clinical virology laboratories. NAT provides a means for rapid and sensitive diagnosis of CMV infection in transplant recipients. Viral quantification also introduced several principles of CMV disease management. Specifically, viral load has been utilized (i) for prognostication of CMV disease, (ii) to guide preemptive therapy, (iii) to assess the efficacy of antiviral treatment, (iv) to guide the duration of treatment, and (v) to indicate the risk of clinical relapse or antiviral drug resistance. However, there remain important limitations that require further optimization, including the interassay variability in viral load reporting, which has limited the generation of standardized viral load thresholds for various clinical indications. The recent introduction of an international reference standard should advance the major goal of uniform viral load reporting and interpretation. However, it has also become apparent that other aspects of NAT should be standardized, including sample selection, nucleic acid extraction, amplification, detection, and calibration, among others. This review article synthesizes the vast amount of information on CMV NAT and provides a timely review of the clinical utility of viral load testing in the management of CMV in solid organ transplant recipients. Current limitations are highlighted, and avenues for further research are suggested to optimize the clinical application of NAT in the management of CMV after transplantation.

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Viral exanthems: An update on laboratory testing of the adult patient

Korman

Alikhan

Kaffenberger

2017

Journal of the American Academy of Dermatology

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Detection of human cytomegalovirus in renal transplantation: Comparison of four diagnostic methods: DNA in sera by polymerase chain reaction (PCR), DNA in leukocyte by PCR, pp65 leukocytic antigenemia, and viremia

Cited by 13 publications

References 3 publications

A follow up study of cytomegalovirus infection in a group of Turkish renal transplant recipients using molecular assays

A follow up study of cytomegalovirus infection in a group of Turkish renal transplant recipients using molecular assays

Clinical Utility of Viral Load in Management of Cytomegalovirus Infection after Solid Organ Transplantation

Viral exanthems: An update on laboratory testing of the adult patient

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