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Quantitative PCR in the diagnosis of CMV infection and in the monitoring of viral load during the antiviral treatment in renal transplant patients.
J Med Virol. 2005 Jul; 76(3):367-72.JM

Abstract

Cytomegalovirus (CMV) infection is a significant problem in transplantation. In this study, a quantitative PCR test was compared with the CMVpp65 antigenemia assay not only in the diagnosis CMV infections but especially in the monitoring of viral loads during ganciclovir treatment of CMV disease in individual renal transplant patients. Altogether 342 blood specimens were obtained from 116 patients. Blood specimens were used for Cobas Amplicor Monitor plasma PCR and for the pp65 assay. Also shell vial culture was performed. The patients with a positive pp65 finding were monitored for CMV weekly during ganciclovir treatment and/or until the antigenemia subsided. CMV was detected in 31/116 (27%) patients, of whom 14 (12%) developed CMV disease and were treated with ganciclovir. CMV was found by shell vial culture in 13/14 cases, but by PCR and pp65 test in all 14 patients. CMV was detected in 156 (45%) samples; by PCR in 121/156 (range 344-103,000 copies/ml) and by pp65 test in 138/156 (range 1-1,000 positive cells/50,000 leukocytes) and by culture in 59/156 (38%) only. The peak viral loads were significantly (P<0.0001) higher in CMV disease than in untreated infections (19,650 vs. 379 copies/ml, and 100 vs. 5pp65 positive cells). In the monitoring of individual patients, the time-related CMV-DNAemia and pp65 antigenemia correlated well during the treatment of CMV disease. In conclusion, Cobas Amplicor Monitor plasma PCR and CMVpp65 antigen assays can be equally used in the diagnosis CMV infection and in the monitoring of viral load during antiviral treatment.

Authors+Show Affiliations

Department of Virology, Helsinki University Central Hospital and Helsinki University, Helsinki, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15902704

Citation

Piiparinen, H, et al. "Quantitative PCR in the Diagnosis of CMV Infection and in the Monitoring of Viral Load During the Antiviral Treatment in Renal Transplant Patients." Journal of Medical Virology, vol. 76, no. 3, 2005, pp. 367-72.
Piiparinen H, Helanterä I, Lappalainen M, et al. Quantitative PCR in the diagnosis of CMV infection and in the monitoring of viral load during the antiviral treatment in renal transplant patients. J Med Virol. 2005;76(3):367-72.
Piiparinen, H., Helanterä, I., Lappalainen, M., Suni, J., Koskinen, P., Grönhagen-Riska, C., & Lautenschlager, I. (2005). Quantitative PCR in the diagnosis of CMV infection and in the monitoring of viral load during the antiviral treatment in renal transplant patients. Journal of Medical Virology, 76(3), 367-72.
Piiparinen H, et al. Quantitative PCR in the Diagnosis of CMV Infection and in the Monitoring of Viral Load During the Antiviral Treatment in Renal Transplant Patients. J Med Virol. 2005;76(3):367-72. PubMed PMID: 15902704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantitative PCR in the diagnosis of CMV infection and in the monitoring of viral load during the antiviral treatment in renal transplant patients. AU - Piiparinen,H, AU - Helanterä,I, AU - Lappalainen,M, AU - Suni,J, AU - Koskinen,P, AU - Grönhagen-Riska,C, AU - Lautenschlager,I, PY - 2005/5/20/pubmed PY - 2005/10/7/medline PY - 2005/5/20/entrez SP - 367 EP - 72 JF - Journal of medical virology JO - J Med Virol VL - 76 IS - 3 N2 - Cytomegalovirus (CMV) infection is a significant problem in transplantation. In this study, a quantitative PCR test was compared with the CMVpp65 antigenemia assay not only in the diagnosis CMV infections but especially in the monitoring of viral loads during ganciclovir treatment of CMV disease in individual renal transplant patients. Altogether 342 blood specimens were obtained from 116 patients. Blood specimens were used for Cobas Amplicor Monitor plasma PCR and for the pp65 assay. Also shell vial culture was performed. The patients with a positive pp65 finding were monitored for CMV weekly during ganciclovir treatment and/or until the antigenemia subsided. CMV was detected in 31/116 (27%) patients, of whom 14 (12%) developed CMV disease and were treated with ganciclovir. CMV was found by shell vial culture in 13/14 cases, but by PCR and pp65 test in all 14 patients. CMV was detected in 156 (45%) samples; by PCR in 121/156 (range 344-103,000 copies/ml) and by pp65 test in 138/156 (range 1-1,000 positive cells/50,000 leukocytes) and by culture in 59/156 (38%) only. The peak viral loads were significantly (P<0.0001) higher in CMV disease than in untreated infections (19,650 vs. 379 copies/ml, and 100 vs. 5pp65 positive cells). In the monitoring of individual patients, the time-related CMV-DNAemia and pp65 antigenemia correlated well during the treatment of CMV disease. In conclusion, Cobas Amplicor Monitor plasma PCR and CMVpp65 antigen assays can be equally used in the diagnosis CMV infection and in the monitoring of viral load during antiviral treatment. SN - 0146-6615 UR - https://www.unboundmedicine.com/medline/citation/15902704/Quantitative_PCR_in_the_diagnosis_of_CMV_infection_and_in_the_monitoring_of_viral_load_during_the_antiviral_treatment_in_renal_transplant_patients_ DB - PRIME DP - Unbound Medicine ER -