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Article: Diagnosing cytomegalovirus disease in CMV seropositive renal allograft recipients: A comparison between the detection of CMV DNAemia by polymerase chain reaction and antigenemia by CMV pp65 assay

TitleDiagnosing cytomegalovirus disease in CMV seropositive renal allograft recipients: A comparison between the detection of CMV DNAemia by polymerase chain reaction and antigenemia by CMV pp65 assay
Authors
KeywordsCMV DNAemia
PCR test
pp65 assay
Renal transplant
Issue Date1997
PublisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CTR
Citation
Clinical Transplantation, 1997, v. 11 n. 4, p. 286-293 How to Cite?
AbstractThe optimal diagnostic test for CMV disease in renal allograft recipients in a locality with a high CMV seropositive rate has not been fully determined. We compared the usefulness of the CMV pp65 antigenemia (CMV-Ag) assay with the detection of DNAemia by a nested polymerase chain reaction (PCR) method in diagnosing CMV disease in 56 renal allograft recipients, of whom 50 (89.2%) were CMV seropositive prior to transplant (tx). Positive CMV-Ag assays were found in 126/281 samples (44.8%) of 27 patients (48.2%) of whom five had seven episodes of CMV disease. The remaining 22 patients were asymptomatic. The symptomatic patients had significantly higher median peak CMV-Ag levels than the asymptomatic patients [800 (160-1380) vs. 5 (1-604) per 2 x 10 5 peripheral blood leukocyte (PBL), p < 0.0001]. One hundred and eight samples were tested by both CMV-Ag and PCR methods. Out of the 108 samples, 89 showed concordant results (37 positive and 52 negative for both tests). Seventeen samples of 11 patients were CMV-Ag negative/PCR positive. Out of these 11 patients, two had CMV disease and the discrepancy in the results was due to blood samples taken after the start of ganciclovir therapy. Falsely negative PCR tests were found in two samples of two patients with positive CMV-Ag assays. With a cutoff antigenemia level of 100 per 2 x 10 5 PBL, the sensitivity, specificity, positive and negative predictive values for diagnosing CMV disease were 100, 96, 71.4 and 100%, respectively. On the other hand, CMV DNAemia was detected in many asymptomatic patients, and the PCR test results correlated poorly with the clinical manifestations of the disease. In symptomatic patients undergoing ganciclovir therapy, the quantification of antigenemia level allowed the assessment of treatment efficacy. In addition, positive CMV-Ag assays at the end of therapy were associated with the subsequent relapse of CMV disease in two patients. The high specificity, together with the short processing time of 4 h, make the CMV-Ag assay the test-of-choice for diagnosing, CMV disease in a renal transplant population with a predominance of CMV seropositive patients.
Persistent Identifierhttp://hdl.handle.net/10722/77390
ISSN
2015 Impact Factor: 1.844
2015 SCImago Journal Rankings: 0.821
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, CYen_HK
dc.contributor.authorHo, KNen_HK
dc.contributor.authorYuen, KYen_HK
dc.contributor.authorLui, SLen_HK
dc.contributor.authorLi, FKen_HK
dc.contributor.authorChan, TMen_HK
dc.contributor.authorLo, WKen_HK
dc.contributor.authorCheng, IKPen_HK
dc.date.accessioned2010-09-06T07:31:23Z-
dc.date.available2010-09-06T07:31:23Z-
dc.date.issued1997en_HK
dc.identifier.citationClinical Transplantation, 1997, v. 11 n. 4, p. 286-293en_HK
dc.identifier.issn0902-0063en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77390-
dc.description.abstractThe optimal diagnostic test for CMV disease in renal allograft recipients in a locality with a high CMV seropositive rate has not been fully determined. We compared the usefulness of the CMV pp65 antigenemia (CMV-Ag) assay with the detection of DNAemia by a nested polymerase chain reaction (PCR) method in diagnosing CMV disease in 56 renal allograft recipients, of whom 50 (89.2%) were CMV seropositive prior to transplant (tx). Positive CMV-Ag assays were found in 126/281 samples (44.8%) of 27 patients (48.2%) of whom five had seven episodes of CMV disease. The remaining 22 patients were asymptomatic. The symptomatic patients had significantly higher median peak CMV-Ag levels than the asymptomatic patients [800 (160-1380) vs. 5 (1-604) per 2 x 10 5 peripheral blood leukocyte (PBL), p < 0.0001]. One hundred and eight samples were tested by both CMV-Ag and PCR methods. Out of the 108 samples, 89 showed concordant results (37 positive and 52 negative for both tests). Seventeen samples of 11 patients were CMV-Ag negative/PCR positive. Out of these 11 patients, two had CMV disease and the discrepancy in the results was due to blood samples taken after the start of ganciclovir therapy. Falsely negative PCR tests were found in two samples of two patients with positive CMV-Ag assays. With a cutoff antigenemia level of 100 per 2 x 10 5 PBL, the sensitivity, specificity, positive and negative predictive values for diagnosing CMV disease were 100, 96, 71.4 and 100%, respectively. On the other hand, CMV DNAemia was detected in many asymptomatic patients, and the PCR test results correlated poorly with the clinical manifestations of the disease. In symptomatic patients undergoing ganciclovir therapy, the quantification of antigenemia level allowed the assessment of treatment efficacy. In addition, positive CMV-Ag assays at the end of therapy were associated with the subsequent relapse of CMV disease in two patients. The high specificity, together with the short processing time of 4 h, make the CMV-Ag assay the test-of-choice for diagnosing, CMV disease in a renal transplant population with a predominance of CMV seropositive patients.en_HK
dc.languageengen_HK
dc.publisherBlackwell Munksgaard. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CTRen_HK
dc.relation.ispartofClinical Transplantationen_HK
dc.subjectCMV DNAemiaen_HK
dc.subjectPCR testen_HK
dc.subjectpp65 assayen_HK
dc.subjectRenal transplanten_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAntigens, Viral - blood - drug effectsen_HK
dc.subject.meshAntiviral Agents - administration & dosage - therapeutic useen_HK
dc.subject.meshCytomegalovirus - drug effects - genetics - immunology - isolation & purificationen_HK
dc.subject.meshCytomegalovirus Infections - diagnosis - drug therapy - immunology - virologyen_HK
dc.subject.meshDNA, Viral - blooden_HK
dc.subject.meshFalse Negative Reactionsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGanciclovir - administration & dosage - therapeutic useen_HK
dc.subject.meshHumansen_HK
dc.subject.meshKidney Transplantationen_HK
dc.subject.meshLeukocytes - virologyen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPhosphoproteins - blooden_HK
dc.subject.meshPolymerase Chain Reactionen_HK
dc.subject.meshPredictive Value of Testsen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshRecurrenceen_HK
dc.subject.meshSensitivity and Specificityen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.subject.meshViral Matrix Proteins - blooden_HK
dc.titleDiagnosing cytomegalovirus disease in CMV seropositive renal allograft recipients: A comparison between the detection of CMV DNAemia by polymerase chain reaction and antigenemia by CMV pp65 assayen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0902-0063&volume=11&spage=286&epage=293&date=1997&atitle=Diagnosing+cytomegalovirus+disease+in+CMV+seropositive+renal+allograft+recipients:+a+comparison+between+the+detection+of+CMV+DNAemia+by+polymerase+chain+reaction+and+antigenemia+by+CMV+pp65+assayen_HK
dc.identifier.emailYuen, KY:kyyuen@hkucc.hku.hken_HK
dc.identifier.emailChan, TM:dtmchan@hku.hken_HK
dc.identifier.authorityYuen, KY=rp00366en_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid9267717-
dc.identifier.scopuseid_2-s2.0-0030814031en_HK
dc.identifier.hkuros27594en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0030814031&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume11en_HK
dc.identifier.issue4en_HK
dc.identifier.spage286en_HK
dc.identifier.epage293en_HK
dc.identifier.isiWOS:A1997XQ57700008-
dc.publisher.placeDenmarken_HK
dc.identifier.scopusauthoridLo, CY=7401771743en_HK
dc.identifier.scopusauthoridHo, KN=36819421100en_HK
dc.identifier.scopusauthoridYuen, KY=36078079100en_HK
dc.identifier.scopusauthoridLui, SL=7102379130en_HK
dc.identifier.scopusauthoridLi, FK=8219093900en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.scopusauthoridLo, WK=7201502414en_HK
dc.identifier.scopusauthoridCheng, IKP=7102537483en_HK

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