Primary cytomegalovirus infection in pregnant egyptian women confirmed by cytomegalovirus IgG avidity testing

To determine the frequency of primary cytomegalovirus [CMV] infection in pregnant Egyptian women using CMV IgG avidity testing. A cross-sectional study was conducted at Suez Canal University Hospital, Ismailia, Egypt. A total of 546 pregnant women, presenting for routine antenatal screening, were tested for CMV IgG and IgM using a commercially available enzyme-linked immunosorbent assay [ELISA]. Sera from CMV IgM-positive women were tested by CMV IgG avidity assay All the 546 pregnant women were seropositive for anti-CMV IgG. Of the 546 women, 40 [7.3%] were positive or equivocal for IgM antibodies. All sera from the 40 women [IgG+/IgM+] showed a high or intermediate CMV IgG avidity index. Of the 40 women, 23 [57.5%] were in the second or third trimesters of pregnancy and had their first-trimester blood retrieved, and the tested CMV IgG avidity assay showed a high avidity index. Women who were IgM positive had no primary CMV infection in the index pregnancy as evidenced by the high CMV IgG avidity testing

Development of CMV quantitative real-time PCR assay validated on white blood cells and plasma samples from kidney transplant recipients

Cytomegalovirus [CMV] has been recognized as the most important viral pathogen in persons undergoing bone marrow and solid organ transplantation. Rapid diagnosis of CMV infection is critical in the management of the disease so that anti-viral therapy can be started early. An in-house quantitative realtime PCR assay based on TaqMan technology was developed and validated using PBLs and plasma samples from kidney transplant recipients with negative and positive antigenemia assay results. In the group of renal transplants with negative antigenemia assay, CMV DNA could be detected in 3 PBLs and one plasma sample, indicating that CMV PCR is more sensitive than antigenemia assay in detection of early CMV reactivation. In the group of patients with positive antigenemia assay, PBLs PCR exhibited equal sensitivity to that of antigenemia assay, furthermore, PBLs were clearly more sensitive and showed higher CMV viral load results compared to plasma samples from patients in the same group. However, none of the plasma specimens with undetectable CMV DNA levels were from patients that later developed active CMV disease, indicating the clinical specificity of plasma samples in determination of active viral replication. We conclude that PBLs based methods increase sensitivity of detection of CMV DNA, whilst those using plasma increase clinical specificity. The developed assay in this study, inclusive of the results of both PBLs and plasma, provides a test of high sensitivity with the quantitative results