High levels of circulating cytomegalovirus DNA reflect visceral organ disease in viremic immunosuppressed patients other than marrow recipients.

Saltzman, Robin; Quirk, Mary; Jordan, M. Colin

doi:10.1172/jci116059

Cited by 78 publications

(57 citation statements)

References 60 publications

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“…As a significant proportion of allogeneic SCT patients develop HCMV disease despite a low systemic viral load, 15,16 sensitive detection methods and a low cutoff value to trigger preemptive antiviral therapy are crucial in these patients. Virus isolation and shell vial culture have been accepted as standards for HCMV detection.…”

Section: Discussionmentioning

confidence: 99%

“…Although a correlation between peak viral load and HCMV disease development was noticed by several other groups in patients after solid organ transplantation and HIV patients, 28,[34][35][36][37][38][39] discordant results have been reported in SCT patients. 15,16,22,31,40 For abbreviations, see Table 1 footnote. Emery et al 40 found both the initial viral load and the increased rate in viral load to be predictive for HCMV disease development in patients after kidney, liver and allogeneic SCT.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, our data support the hypothesis that in allogeneic SCT patients, in contrast to patients after solid organ transplantation, HCMV disease can develop in spite of low levels of HCMV viral load. 15,16 As there is evidence that immune reconstitution occurs earlier after peripheral blood SCT than after bone marrow transplantation, 41 we analyzed whether graft type could be a risk factor for HCMV disease development. Surprisingly, disease incidence in patients diagnosed with HCMV infection was not increased in the bone marrow transplant group, and was also not influenced by donor type (related vs unrelated).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the COBAS Amplicor HCMV Monitor for early detection and monitoring of human cytomegalovirus infection after allogeneic stem cell transplantation

Lengerke

Ljubicic

Meisner³

et al. 2006

Bone Marrow Transplant

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Early diagnosis of human cytomegalovirus (HCMV) infection and the introduction of preemptive antiviral therapy have reduced HCMV-related mortality after allogeneic stem cell transplantation. A critical goal remains stratifying risk profiles and minimizing potential harm owing to antiviral overtreatment. We compared the commercially available standardized COBAS Amplicor CMV Monitor (CACM) to an in-house PCR assay, for the monitoring of HCMV infection. Seventy-two patients were surveyed by an in-house PCR of whole blood, quantitative viral load assessment by CACM and virus culture assays in a prospective and a retrospective study. A high concordance between CACM and PCR was documented. The viral load at onset correlated with the peak viral load (Spearman rank correlation R ¼ 0.634, P ¼ 0.0004). In patients developing HCMV disease, both viral loads were in trend higher (P ¼ 0.823, respectively P ¼ 0.053), and the viremic episodes longer (P ¼ 0.015), as compared to asymptomatically HCMV-infected patients. The serological pre-transplant status was the major risk factor for the development of HCMV disease, showing highest risk for seropositive patients receiving a seronegative graft, whereas donor type (related or unrelated) and graft type (bone marrow or peripheral blood mobilized stem cells) did not have an influence. HCMV infection proved to be a risk factor for the development of non-viral opportunistic infections (P ¼ 0.002).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of the COBAS Amplicor HCMV Monitor for early detection and monitoring of human cytomegalovirus infection after allogeneic stem cell transplantation

Lengerke

Ljubicic

Meisner³

et al. 2006

Bone Marrow Transplant

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“…Thus, studies applying less sensitive techniques to quantify the CMV-DNA load in leukocytes did not detect differences in viral loads between patients with symptomatic and asymptomatic CMV infection. 23 In the study reported, the highest peak titers of CMV-DNA as assessed by HCS (v 2.0) were found in the two patients with fatal CMV disease.…”

Section: Discussionmentioning

confidence: 79%

“…In recipients of solid organ transplants and in patients with AIDS, CMV-related symptoms were found to be associated with a high viral load in the blood. 17,22,23 In comparison, viral loads were found to be significantly lower in recipients of an allogeneic stem cell transplant, even in patients with CMV disease. Thus, studies applying less sensitive techniques to quantify the CMV-DNA load in leukocytes did not detect differences in viral loads between patients with symptomatic and asymptomatic CMV infection.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Murex CMV DNA Hybrid Capture assay (version 2.0) for early diagnosis of cytomegalovirus infection in recipients of an allogeneic stem cell transplant

Hebart

Wuchter

Loeffler

et al. 2001

Bone Marrow Transplant

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Summary:Early diagnosis of CMV infection based on sensitive diagnostic assays has helped to reduce CMV-related mortality after allogeneic stem cell transplantation (SCT). In this study, the commercialized Murex CMV DNA Hybrid Capture assay (version 2.0) (HCS) was prospectively compared to an in-house CMV-DNA PCR assay from whole blood in patients after allogeneic stem cell transplantation. Overall, a high concordance between HCS and PCR was documented (kappa = 0.686; n = 385). The HCS assay was found to be as sensitive as the PCR indicating active CMV infection at a median of 35 and 34 days after transplantation, respectively. None of the HCS-negative patients developed CMV-related symptoms (negative predictive value 100%). Declining CMV DNA load in the blood was found to be an indicator for effective antiviral therapy, whereas persistence of a high viral load was associated with fatal CMV disease. In conclusion, the Hybrid Capture CMV DNA assay (v 2.0) allows early diagnosis of CMV infection after allogeneic SCT and assessment of the efficacy of antiviral therapy. Bone Marrow Transplantation (2001) 28, 213-218.

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Distinguishing the States of Latency and Reactivation Is Important for Human Herpesvirus 8

Drago¹,

Rebora²

1998

Archives of Dermatology

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High levels of circulating cytomegalovirus DNA reflect visceral organ disease in viremic immunosuppressed patients other than marrow recipients.

Cited by 78 publications

References 60 publications

Evaluation of the COBAS Amplicor HCMV Monitor for early detection and monitoring of human cytomegalovirus infection after allogeneic stem cell transplantation

Evaluation of the COBAS Amplicor HCMV Monitor for early detection and monitoring of human cytomegalovirus infection after allogeneic stem cell transplantation

Evaluation of the Murex CMV DNA Hybrid Capture assay (version 2.0) for early diagnosis of cytomegalovirus infection in recipients of an allogeneic stem cell transplant

Distinguishing the States of Latency and Reactivation Is Important for Human Herpesvirus 8

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