E. Drouet et al., MONITORING LEVELS OF HUMAN CYTOMEGALOVIRUS DNA IN BLOOD AFTER LIVER-TRANSPLANTATION, Journal of clinical microbiology, 33(2), 1995, pp. 389-394
We evaluated a semiquantitative PCR assay prospectively in 40 liver tr
ansplant recipients as an aid in making a prompt diagnosis of cytomega
lovirus (CMV) infection, For 2 months after transplantation, clinical
specimens from patients were tested weekly by PCR, virus isolation fro
m peripheral blood and urine, and CMV serology, The incidence of activ
e CMV infection was 70%, The levels of CMV DNA determined by hybridiza
tion of PCR samples and densitometric scanning of blots were assigned
a score of 1 to 4 by comparison with four external standards amplified
in parallel and corresponding to a range of 80 to 80,000 genomes. The
first detection of CMV in blood by PCR occurred at a mean of 15 days,
and high-level PCR scores of 3 or 4 were obtained 21 days after trans
plantation, whereas viremia occurred 33 days after transplantation. Si
gnificantly higher levels of CMV DNA were seen in patients with CMV di
sease (P < 0.05) than in asymptomatic patients, The prevalence of symp
tomatic CMV infection was 30%, The positive predictive value of PCR wa
s 48%, while the negative predictive value was 100%, After treatment,
the clearance of CMV DNA was always observed and the disappearance of
symptoms occurred concomitantly with undetectable PCR signals.