Comparison between antigenemia and a quantitative-competitive polymerase chain reaction for the diagnosis of cytomegalovirus infection after heart transplantation

Background Antigenemia and quantitative polymerase chain reaction (PCR) are widely used for cytomegalovirus (CMV) diagnosis after heart transplantatio n due to their enhanced, predictive values for disease detection when speci fic cut-off Values are used. The purpose of this study was to compare, in t he same patient setting, the predictive values of quantitative PCR and anti genemia for GMV disease detection, using specific cut-off values. Methods. Thirty heart transplant receptors were prospectively monitored for active CMV infection and disease detection, using quantitative PCR and ant i-genemia, Positive and negative predictive values for CMV disease detectio n were calculated using cut-off values for both antigenemia (5 and 10 posit ive cells/ 300,000 neutrophils) and quantitative-PCR (50,000 and 100,000 co pies/10(6) leukocytes). Results, Active CMV infection was diagnosed in 93.3% of patients and CMV di sease in 23.3%, The positive and negative predictive (%) values for CMV dis ease detection were 35/100 and 46.7/100, respectively, for quantitative PCR and antigenemia. Using 5 and 10 positive cells/300,000 neutrophils as cut- off values for antigenemia, the positive and negative predictive values (%) for disease detection were respectively 63.6/100 and 70/100, For quantitat ive PCR, the positive and negative predictive values (%) for cut-off values of 50,000 and 100,000 copies/10(6) leukocytes were 53.8/100 and 60/94.1, r espectively. Conclusion. in our series, antigenemia and quantitative-PCR had enhanced an d similar predictive values for CMV disease detection when specific cut-off values were used. The choice between these two methods for disease detecti on may rely less on their efficiency and more on the experience and familia rity with them.