DIAGNOSTIC-VALUE OF MONITORING HUMAN CYTOMEGALOVIRUS LATE PP67 MESSENGER-RNA EXPRESSION IN RENAL-ALLOGRAFT RECIPIENTS BY NUCLEIC-ACID SEQUENCE-BASED AMPLIFICATION

The diagnostic value of monitoring human cytomegalovirus (HCMV) late p p67 mRNA expression by nucleic acid sequence-based amplification (NASB A) after renal-allograft transplantation was evaluated, RNAs were isol ated from 489 whole-blood specimens of 42 patients for the specific am plification of the late pp67 (UL65) mRNA, NASBA results were compared to results from the pp65 antigenemia assay, virus isolation by cell cu lture, and serology, The sensitivity value for NASBA proved to be high er than that for the antigenemia assay (50 versus 35%) for the detecti on of HCMV infection, while the sensitivity values of cell culture and NASBA were comparable (54 and 50%, respectively). NASBA detected the onset of HCMV infection simultaneously with cell culture and the antig enemia assay. Both the antigenemia assay and NASBA are very specific ( 100%) and highly predictive (100%) for the onset of HCMV infection. An tiviral therapy with ganciclovir resulted in negative results for cell culture, the antigenemia assay, and NASBA. In conclusion, monitoring HCMV pp67 mRNA expression by NASBA is a highly specific method for the detection of HCMV infection in renal-allograft recipients and is more sensitive than the antigenemia assay. Furthermore, NASBA can be used to monitor the progression of HCMV infections and the effect of antivi ral therapy on viral activity.