Clinical Trial of Quantitative Real-Time Polymerase Chain Reaction for Detection of Cytomegalovirus in Peripheral Blood of Allogeneic Hematopoietic Stem-Cell Transplant Recipients

J Infect Dis. 2003 Oct 1;188(7):967-72. doi: 10.1086/378413. Epub 2003 Sep 11.

Abstract

The preemptive therapy of cytomegalovirus (CMV) reactivation is useful for the prevention of CMV disease in allogeneic hematopoietic stem-cell transplant (HSCT) recipients. We compared results of the pp65 CMV antigenemia test with quantitative touch-down polymerase chain reaction (Q-PCR) on unfractionated whole blood for the detection of CMV reactivation in 51 HSCT recipients. Forty episodes of reactivation in 28 patients were detected by antigenemia and treated by antiviral drugs. Q-PCR detected CMV DNA in 39 (97.5%) of 40 reactivation episodes. False-positive results occurred in 3% of tests, of which 63% were borderline positive. Q-PCR results were positive earlier than antigenemia results in 30 (77%) of 39 episodes detected by antigenemia. Q-PCR remained positive after treatment was discontinued in 14 (36%) of 39 episodes and predicted the return of CMV reactivation in 4 (31%) of 13 episodes. Q-PCR was more sensitive than the antigenemia test and had sufficient specificity for clinical use.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Viral / blood
  • Antiviral Agents / therapeutic use
  • Child
  • Cytomegalovirus / genetics*
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / blood
  • Cytomegalovirus Infections / prevention & control
  • Cytomegalovirus Infections / virology*
  • False Positive Reactions
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Middle Aged
  • Polymerase Chain Reaction / methods*
  • Prospective Studies
  • Reproducibility of Results
  • Virus Activation
  • Virus Replication

Substances

  • Antigens, Viral
  • Antiviral Agents