DIAGNOSTIC-VALUE OF AMPLIFICATION OF HUMAN CYTOMEGALOVIRUS DNA FROM GASTROINTESTINAL BIOPSIES FROM HUMAN IMMUNODEFICIENCY VIRUS-INFECTED PATIENTS

In order to assess the value of human cytomegalovirus (HCMV) DNA ampli fication of gastrointestinal biopsies, we studied 57 human immunodefic iency virus-infected patients with and without gastrointestinal HCMV d iseases. After DNA extraction, a 406-bp fragment from the unique short region of the HCMV genome was amplified by 35 cycles of polymerase ch ain reaction (PCR) and semiquantified from 80 to 80,000 HCMV genomic c opies. Among 12 non-AIDS patients, the PCR assay was negative for 11 o f 12 duodenal and 8 of 8 colorectal samples. It was also negative for 28 of 31 duodenal and 12 of 15 colorectal samples from 31 AIDS patient s without gastrointestinal HCMV diseases. Among 14 AIDS patients with gastrointestinal HCMV diseases, the PCR assay was positive for 12 of 1 2 patients with HCMV duodenitis and for 13 of 13 patients with HCMV co litis. Results were dichotomized between high and low HCMV-DNA copy nu mbers. For duodenitis, sensitivity was 92% and specificity was 100%. F or colitis, sensitivity was 92% and specificity was 93%. Specificity a nd sensitivity were not influenced by shedding status for HCMV or by o ther gastrointestinal infections. HCMV DNA amplification of gastrointe stinal biopsies is a sensitive and specific tool for the diagnosis of gastrointestinal HCMV diseases in AIDS patients.