COMPARATIVE-EVALUATION OF THE CYTOMEGALOVIRUS DNA LOAD IN POLYMORPHONUCLEAR LEUKOCYTES AND PLASMA OF HUMAN IMMUNODEFICIENCY VIRUS-INFECTED SUBJECTS

The cytomegalovirus (CMV) DNA load was determined in polymorphonuclear leukocytes (PMNL) and plasma samples from 106 human immunodeficiency virus-infected subjects at risk of developing CMV disease (group 1) an d from 27 AIDS patients with documented CMV disease (group 2). For bot h groups, the number of CMV copies in PMNL was significantly higher th an in plasma when results were derived from an equivalent blood volume (P < .001, PMNL vs. plasma). Additionally, group 2 (symptomatic) pati ents had a greater viral DNA load than group 1 (asymptomatic) subjects (P < .001 for both PMNL, and plasma). The sensitivity, specificity, a nd positive and negative predictive values of qualitative polymerase c hain reaction using PMNL (PCR-PMNL) for the presence of CMV disease we re 100%, 58%, 38%, and 100%, respectively, compared with 70%, 93%, 74% , and 92% for qualitative PCR-plasma and 93%, 92%, 76%, and 98% for qu antitative PCR-PMNL using a cutoff of 16,000 copies/mL. Thus, the best strategy for diagnosing CMV disease in these individuals relies on qu antitative assessment of the viral DNA load in PMNL.