EVALUATION OF ANTIGEN AND ANTIBODY DETECTION IN URINE SPECIMENS FROM CHILDREN WITH CONGENITAL HUMAN CYTOMEGALOVIRUS-INFECTION

Fetal infection with human cytomegalovirus (HCMV) is the leading viral cause of brain damage among newborns at birth or later in life. Effor ts to screen newborns routinely for shedding of the virus by immunoass ay have-been hampered by inhibitors in urine, reportedly the host prot ein beta2-microglobulin (beta 2m). An enzyme-linked immunosorbent assa y (ELISA) was developed for the detection of HCMV antigen in which the reactivity was not affected by the presence of beta 2m, but neverthel ess inhibition was observed when urine samples with high levels of vir us were tested. The presence of antibodies to HCMV was demonstrated in these urine samples by antibody ELISA and immunoblot using the major antigenic protein of HCMV (pp150) expressed in Escherichia coli; this offers an alternative explanation for the inhibition in ELISA. The pre sence of HCMV antibodies correlated significantly with congenital HCMV infection (as detected by tissue culture isolation of virus from urin e samples of newborns), especially with asymptomatic cases (sensitivit y 70%; specificity 94%). The data indicate a local (renal) immune resp onse to HCMV in congenitally infected children, which may have future diagnostic applications. (C) 1995 Wiley-Liss, Inc.