SHELL-VIAL CULTURE AND PP65 ANTIGENEMIA ASSAY IN THE DETECTION OF CYTOMEGALOVIRUS IN THE FIRST BLOOD-SAMPLE OF RENAL-TRANSPLANT RECIPIENTS

The aim of the study was to compare the efficacy of pp65 antigenemia a ssay and the shell-vial culture (SVC; viremia) for the diagnosis of cy tomegalovirus (CMV) infection in renal transplant recipients, comparin g the results obtained in the first blood sam pie a nd the total numbe r of blood samples analyzed in this group of patients. During the stud y period, 70 renal transplant recipients were studied: 44 (62.8%) with CMV infection. The method of sedimentation in a dextran solution for leukocyte extraction was used in the pp65 antigenemia assay. The MRC-5 shell-vial assay was used for CMV isolation from leukocytes (viremia) . Eighty blood samples were examined from 70 renal transplant recipien ts: Of the 44 positive samples studied, in 77.5% of cases, both the an tigenemia assay and the SVC were positive. In 16.2%, only the antigene mia assay was positive, and, in 6.2%, only the SVC was positive. In al l blood samples studied, the antigenemia was present in 93.7% of cases , and the SVC was present in 83.7% (P= 0.04). If the results obtained in only the first blood sample taken for the diagnosis are studied, th en we observe that the antigenemia assay was positive in 39 patients ( 88.6%), whereas the SVC was positive in 41 patients (93.1%), although the difference was not statistically significant(P= 0.39). It is concl uded that the inoculation of all of the leukocytes extracted from bloo d samples in the SVC seems to produce a slight increase in the sensiti vity of the cell culture and that the SVC becomes positive before the antigenemia for the detection of CMV in peripheral blood, especially i n the first blood sample. (C) 1998 Wiley-Liss, Inc.