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 Original Articles |
| Semiquantitative Polymerase Chain Reaction and Immunocytochemical Assay for Early Detection of Cytomegalovirus Infection in Renal Transplant Patients |
| Seong Heon Wie, Yang Ree Kim, Jung Hyun Choi, Jin Hong Yoo, Chul Woo Yang, Wan Shik Shin, Byung Kee Bang, Moon Won Kang |
| Department of Internal Medicine, Catholic University Medical College, Seoul, Korea |
Vol.28 Num.2 (p105~111)
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Background : Cytomegalovirus(CMV) attacks about 35% of kidney transplant recipients and is reported to be the direct cause of death in 2% of renal transplant recipients. The most specific diagnostic method for CMV infection is isolation of the virus by culture. However, viral culture takes too much time to detect CMV infection and CMV antibody titers may not be elevated among immunocompromised patients. Therefore, rapid and sensitive methods for detection of CMV viremia are required. Semiquantitative polymerase chain reaction(PCR) and antigenemia assay can be used for rapid diagnosis of CMV viremia.
Methods : We performed a prospective study using semiquantitative PCR and antigenemia assay for rapid detection of CMV viremia in 187 blood specimens from 28 renal transplant recipients at weekly or biweekly interval for 3 months after transplantation. Results : 1) PCR assay was positive in 12(42.9%) and CMV antigenemia was noted in 13(46.4%) out of 28 renal transplant recipients during 3 month period after transplantation.
2) Out of 187 specimens, 30(16%) were positive by the PCR assay and 34(18.2%) were positive by the CMV antigenemia assay.
3) Twenty eight(93.3%) of 30 PCR-positive specimens were positive by CMV antigenemia assay and 151(96.2%) of 157 PCR-negative specimens were negative by CMV antigenemia assay.
4) CMV DNA levels were significantly associated with CMV antigen-positive cells.
5) Serologic tests also were performed in 115 of 187 specimens. Among 20 PCR positive from 9 recipients, only 3 from 2 recipients were positive by serologic test using ELISA method. Among 95 PCR-negative specimens from 22 recipients, 4 specimens from 2 recipients were positive by the serologic test.
Conclusion : These results suggest that semiquantitative PCR and the CMV antigenemia assay be useful for early detection of CMV infection in patients with renal transplantation.
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Keywords : Kidney Transplant, Cytomegalovirus, Antigenemia, Polymerase chain reaction |
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