DIAGNOSTICS OF PERSISTENT VIRUSES - HUMAN CYTOMEGALOVIRUS AS AN EXAMPLE

Infections with persistent viruses such as herpesviruses have become o f significant clinical importance with the increasing number of immuno compromized patients at risk to suffer from severe disease. As antivir al chemotherapy is available for herpesvirus infections, the diagnosti c methods for rapid and sensitive detection of symptomatic infection h ave been developed and recently refined. In human cytomegalovirus (HCM V), the use of recombinant viral antigens provides a rationale to impr ove serological assays. This may be of use for the discrimination of p rimary versus secondary infection. Early diagnosis of symptomatic HCMV infection in immunosuppressed patients can be most effectively achiev ed by the detection of a viral tegument protein, pp65, in peripheral b lood leukocytes. This early diagnosis has been shown to be of major im portance for the effective treatment of these patients. HCMV infection in solid organs can be demonstrated by immunohistochemistry using mon oclonal antibodies against viral proteins. HCMV involvement in disease s of the central nervous system in AIDS patients can be verified by th e detection of very small amounts of HCMV DNA in cerebrospinal fluid b y polymerase chain reaction. This method may prove useful for monitori ng HCMV encephalitis and neuropathy.