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Quantitation of cytomegalovirus (CMV) DNA by real‐time PCR for occurrence of CMV disease in HIV‐infected patients receiving highly active antiretroviral therapy
Author(s) -
Gourlain Karine,
Salmon Dominique,
Gault Elyanne,
Leport Catherine,
Katlama Christine,
Matheron Sophie,
Costagliola Dominique,
Mazeron MarieChristine,
Fillet AnneMarie
Publication year - 2003
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.10303
Subject(s) - taqman , concordance , virology , viral load , betaherpesvirinae , human cytomegalovirus , cytomegalovirus , viral disease , medicine , immunology , real time polymerase chain reaction , viremia , biology , herpesviridae , virus , gene , biochemistry
In HIV‐infected patients treated with highly active antiretroviral therapy (HAART) included in the Predivir cohort, we have evaluated the usefulness of CMV DNA quantitation by a TaqMan ® PCR assay from peripheral blood leukocytes (PBLs) to predict CMV disease occurrence. In parallel with the immune restoration after treatment by HAART, the percentage of positive samples decreased progressively from 7.3% at Day 0 to 3.5% at Month 12. Among the CMV markers, the smallest concordance with PBL CMV TaqMan ® PCR, as evaluated by kappa, was observed with pp65 antigenemia, whereas concordance with all other CMV markers was high. Among the 16 patients with CMV DNA copies at least once >100/150,000 cells, CMV disease occurred in six during follow‐up, whereas among the 159 patients with CMV DNA copies always <10/150,000 cells, CMV disease occurred in three and among the seven patients with CMV DNA copies >10 and <100 occurred in only one. In univariate Cox models, all the CMV markers including PBL CMV TaqMan ® PCR >10/150,000 cells (RR: 27.6, IC95: 7.1–107.2), the CD4 cell count <75 cells/mm 3 and the HIV viral load >100,000 copies/ml were predictive for CMV disease. In a stepwise multivariate analysis, which should be interpreted with caution due to the small number of events (n = 10), three covariates were associated independently with CMV disease: pp65 antigenemia >100 nuclei/200,000, PBL CMV TaqMan ® PCR >10 copies/150,000 cells and HIV viral load remaining or increasing >100,000 copies/ml. J. Med. Virol. 69:401–407, 2003. © 2003 Wiley‐Liss, Inc.