Distinguishing Cytomegalovirus (CMV) Infection and Disease with CMV Nucleic Acid Assays

Caliendo, Angela M.; George, Kirsten St.; Allega, Jessica; Bullotta, Arlene; Gilbane, Lisa; Rinaldo, Charles R.

doi:10.1128/jcm.40.5.1581-1586.2002

Cited by 66 publications

(36 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CMV QNAT is the main alternative option to antigenemia (63)(64)(65)(66)(67)(68)(69). The testing requires expensive equipment and specialized expertise.…”

Section: Diagnosismentioning

confidence: 99%

CMV: Prevention, Diagnosis and Therapy

Kotton

2013

American Journal of Transplantation

244

218

View full text Add to dashboard Cite

Cytomegalovirus (CMV) is the most common infection after organ transplantation and has a major impact on morbidity, mortality and graft survival. Optimal prevention, diagnosis and treatment of active CMV infection enhance transplant outcomes, and are the focus of this section. Methods to prevent CMV include universal prophylaxis and preemptive therapy; each has its merits, and will be compared and contrasted. Diagnostics have improved substantially in recent years, both in type and quality, allowing for more accurate and savvy treatment; advances in diagnostics include the development of an international standard, which should allow comparison of results across different methodologies, and assays for cellular immune function against CMV. Therapy primarily involves ganciclovir, now rendered more versatile by data suggesting oral therapy with valganciclovir is not inferior to intravenous therapy with ganciclovir. Treatment of resistant virus remains problematic, but is enhanced by the availability of multiple novel therapeutic agents.

show abstract

“…CMV QNAT is the main alternative option to antigenemia (63)(64)(65)(66)(67)(68)(69). The testing requires expensive equipment and specialized expertise.…”

Section: Diagnosismentioning

confidence: 99%

CMV: Prevention, Diagnosis and Therapy

Kotton

2013

American Journal of Transplantation

244

218

View full text Add to dashboard Cite

show abstract

“…is an employee of AcroMetrix Corp. therapeutic response. [1][2][3][4][5][6][7][8][9][10][11] Therefore, accurate, sensitive, and precise diagnostic tests that can detect and quantitate CMV viral load are essential.…”

Section: Viral Load (Vl) Assessment Of Cytomegalovirus (Cmv)mentioning

confidence: 99%

Multi-Site PCR-Based CMV Viral Load Assessment-Assays Demonstrate Linearity and Precision, but Lack Numeric Standardization

Wolff

Heaney

Neuwald

et al. 2009

The Journal of Molecular Diagnostics

View full text Add to dashboard Cite

Viral load (VL) assessment of cytomegalovirus (CMV)by real-time PCR is an important tool for diagnosing and monitoring CMV viremia in patients with compromised immune systems. We report results from a sample exchange organized by members of the Association for Molecular Pathology that compared PCR results from 23 laboratories; 22 such laboratories used a laboratory-developed real-time PCR assay and one laboratory used a competitive PCR assay. The samples sent to each laboratory were comprised of a dilution panel of CMV virion-derived reference materials that ranged from 0 to 500 ,000 copies/ml. Accuracy , linearity , and intralaboratory precision were established for the different laboratory-developed assays. Overall , PCR results were linear for each laboratory (R 2 > 0.97 in all but two). While 13 laboratories showed no significant quantitative assay bias , 10 laboratories reported VLs that were significantly different compared with expected values (bias range, ؊0.82 to 1.4 logs). The intralaboratory precision [mean coefficient of variance of 2% to 5% (log-scale)] suggested that changes in VLs of less than 3-to fivefold may not be significantly different. There was no significant association between laboratory-specific technical variables (PCR platform , calibrator , extraction method) and assay linearity or accuracy. These data suggested that , within each laboratory , relative VL values were linear, but additional method standardization and a CMV DNA reference standard are needed to allow laboratories to achieve comparable numeric results. Cytomegalovirus (CMV) is a double-stranded DNA virus that is a member of the Herpesviridae family. Establishment of persistent and latent infections with CMV in the human host is a common occurrence. With seropositivity rates at 80% and CMV viral reactivation being associated with a compromised immune system, CMV is considered one of the most common opportunistic pathogens leading to life-threatening illnesses in the immunocompromised patient. Quantitative CMV viral load (VL) testing has been shown to be useful in diagnosing active disease, screening for preemptive therapy, and monitoring

show abstract

“…For both tests, it is important to avoid overinterpretation of small changes in viral load, particularly near the limits of detection of the tests. However, studies have shown that both the Amplicor and the Hybrid Capture tests are useful in monitoring viral load changes in response to therapy (1,4,12).…”

Section: Discussionmentioning

confidence: 99%

“…The clinical utility of quantitative CMV DNA tests in managing these patient groups has been well documented (1,4,6,(12)(13)(14). In transplant recipients, CMV load is used to diagnose active CMV disease, screen patients for the use of preemptive therapy, and monitor the response to antiviral therapy (1,4,6,11). In patients infected with human immunodeficiency virus type 1, the risk of developing CMV disease has been reported to be directly related to the quantity of CMV DNA in plasma (13,14).…”

mentioning

confidence: 99%