COMPARISON OF NESTED PCR FOR DETECTION OF DNA IN PLASMA WITH PP65 LEUKOCYTIC ANTIGENEMIA PROCEDURE FOR DIAGNOSIS OF HUMAN CYTOMEGALOVIRUS-INFECTION

A nested PCR was used for the detection of human cytomegalovirus (HCMV ) DNA in plasma. The presence of HCMV DNA and its correlation to pp65 leukocytic antigenemia were investigated with 299 blood samples from 4 5 organ transplant recipients and 63 AIDS patients. Of the 53 samples positive by nested PCR, 52 (98%) were also positive for leukocytic ant igenemia and 23 had high levels of antigenemia (>50 positive cells per 2 x 10(5) leukocytes). Of the 246 samples negative in PCR, only 3 (1. 2%) had highly positive antigenemia. For 15 patients having a high ant igenemia level in the course of their disease, consecutive blood sampl es were studied and also assessed for,viremia in culture. The extent t o which HCMV DNA, detected by PCR, was present in plasma correlated wi th increased levels of HCMV leukocytic antigenemia for six of the eigh t AIDS patients and for all the organ transplant recipients. Positivit y for HCMV DNA in PCR and for viremia in cell culture was usually rest ricted to the highest antigenemia levels. From a total pf 69 blood sam ples, PCR and culture gave positive results, respectively, for 17 of 3 2 samples (53%) and 14 of 32 samples (43%) from transplant recipients and for 15 of 37 samples (40%) and 9 of 37 samples (24%) from AIDS pat ients. Our findings have shown 9 strong correlation between high level s of leukocytic antigenemia and HCMV DNA in plasma. The detection of H CMV DNA in plasma by this nested PCR can prove HCMV dissemination in b lood, but it lacks the rapidity and simplicity of the leukocytic pp65 antigenemia procedure.