SERUM POLYMERASE CHAIN-REACTION FOR CYTOMEGALOVIRUS DNA FOR MONITORING GANCICLOVIR TREATMENT IN AIDS PATIENTS

The virological response to antiviral treatment of cytomegalovirus (CM V) infection in patients with AIDS can be monitored by the identificat ion and quantification of CMV pp65 antigen in blood polymorphonuclear leukocyte cells (PMNL). To assess the value of nested polymerase chain reaction (PCR) in serum for therapy follow-up, we compared PCR and pp 65 antigenemia results in 21 acquired immune deficiency syndrome (AIDS ) patients with CMV infection, before and after 3 weeks of intravenous ganciclovir at standard doses. pp65 antigenemia was positive in 18/21 (86%) patients at the start of the therapy and in 2/15 (13%) at the e nd of therapy. CMV DNA was found in serum from 18/21 (86%) patients at the beginning of therapy and in 3/21 (14%) patients after 3 weeks of therapy. A clinical improvement was seen in 16/21 (76%) patients: 11/1 6 (69%) mere negative by both PCR and antigenemia at the end of gancic lovir treatment. The sensitivity and specificity of serum PCR versus t he antigenemia assay were 85% and 81%, respectively. Nested PCR on ser um can be useful for treatment follow-up of CMV infection in patients with AIDS. It can be used where antigenemia cannot be performed and in retrospective studies.