Comparison of Cytomegalovirus Antigenemia with Roche Amplicor CMV test for Detection of Cytomegalovirus Infection in Bone Marrow Transplant Recipients / 대한임상병리학회지

ABSTRACT

BACKGROUND: CMV Antigenemia (CMV-Ag) assay and polymerase chain reaction (PCR) have been introduced as exponents of a new generation of tests for the detection of CMV infection. So we compared Roche Amplicor test with CMV-Ag assay to evaluate their clinical usefulness. METHODS: CMV-Ag assay using CMV-vueTM kit (INCSTAR Co., U.S.A.) detects pp65 antigen in leukocytes by immunoperoxidase detection system (positive; stained nucleus > OR =1). Amplicor CMV test (Roche Diagnostic Systems, Inc., Branching, NJ, USA) using plasma or serum is based on PCR amplification of target DNA using CMV specific biotinylated primer and hybridization of the amplified products to the probe and subsequent colorimetric detection of amplified DNA. RESULTS: Of the bone marrow transplanted 73 cases, eleven cases showed discrepancy between the two methods. Of these 10 cases those showed positive results only by Amplicor CMV test, 9 cases turned out to be true positive by the follow-up test and clinical manifestation. And the remaining one case was thought to be false positive. One case which showed positive result only by CMV-Ag assay was proved to be true positive. Consequently, CMV-Ag assay had sensitivity of 73.5% and specificity of 100%, Amplicor CMV test had 97.1% and 97.4%, respectively. Amplicor CMV test detected CMV DNA average 16.3 days before the onset of clinical manifestation and sustained until 10 days after symptoms disappearance, otherwise CMV-Ag assay detected mean 3.8 days earlier and sustained 4.2 days after. CONCLUSIONS: Amplicor CMV test is more sensitive, rapid and longer sustained method than CMV-Ag assay but it lacks quantitation.