Comparison of quantitative cytomegalovirus (CMV) PCR in plasma and CMV antigenemia assay: Clinical utility of the prototype AMPLICOR CMV MONITOR testin transplant recipients

The correlation between the prototype AMPLICOR CMV MONITOR test (Roche Mole cular Systems), a quantitative PCR assay, and the cytomegalovirus (CMV) pp6 5 antigenemia assay was evaluated in transplant recipients. Sequential bloo d specimens were collected on 29 patients (491 specimens), the leukocyte fr action was tested by CMV antigenemia, and quantitative PCR was performed on plasma specimens. None of the 15 patients (242 specimens) who were antigen emia negative were positive For CMV DNA by PCR, and none of these patients developed active CMV disease. There were 14 antigenemia-positive patients. 8 of whom developed active CMV disease. In all patients, there was a good a ssociation between the antigenemia and PCR assays. Ganciclovir-resistant vi rus was isolated from three patients with active CMV disease. These three p atients had persistently elevated levels of antigenemia and CMV DNA by PCR when resistance to ganciclovir developed. This standardized, quantitative C MV PCR assay on plasma has clinical utility for the diagnosis of active dis ease and in monitoring the response to antiviral therapy in transplant reci pients.