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Analysis of cytomegalovirus (CMV) viremia using the pp65 antigenemia assay, the amplicor CMV test, and a semi‐quantitative polymerase chain reaction test after allogeneic marrow transplantation
Author(s) -
Ksouri H.,
Eljed H.,
Greco A.,
Lakhal A.,
Torjman L.,
Abdelkefi A.,
Othmen T. Ben,
Ladeb S.,
Slim A.,
Zouari B.,
Abdeladhim A.,
Hassen A. Ben
Publication year - 2007
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/j.1399-3062.2006.00171.x
Subject(s) - viremia , concordance , medicine , polymerase chain reaction , cytomegalovirus , real time polymerase chain reaction , virology , immunology , human cytomegalovirus , betaherpesvirinae , herpesviridae , viral disease , virus , biology , gene , biochemistry
A pp65 antigenemia assay for polymorphonuclear leukocytes (PMNLs) (CINAkit Rapid Antigenemia), and a qualitative polymerase chain reaction (PCR) test for plasma ‘PCR‐P qual’ (Amplicor cytomegalovirus [CMV] test) were performed for 126 samples (blood and plasma) obtained from 18 bone marrow transplant patients, over a 9‐month surveillance period. Among those samples, 92 were assayed with a semi‐quantitative PCR test for PMNLs ‘PCR‐L quant.’ The number of samples with a positive CMV test for antigenemia and PCR‐P qual assays was 20.63% and 12.7%, respectively, whereas the PCR‐L quant assay was positive in 48 of the 92 samples assayed (52.17%). The rates of concordance of the results of PCR‐P qual and antigenemia, PCR‐P qual and PCR‐L quant, antigenemia and PCR‐L quant were 92%, 65.2% and 66.8%, respectively. The analysis of the results for the 92 specimens tested by all 3 methods showed a rate of concordance of 63% among all methods. Good agreement (κ=0.72) was found only between pp65 Ag and PCR‐P qual assays. Clinical disease correlates with an antigenemia high viral load. Three patients had CMV disease despite preemptive therapy, and all of them had graft‐versus‐host‐disease (GVHD). PMNLs‐based assays are more efficient in monitoring CMV reactivation, but for high‐risk patients with GVHD, more sensitive assays (real‐time PCR) must be done.