Comparison between CMV quantitative PCR and CMV-pp65 antigen test for detection of CMV infection in allogeneic hematopoietic stem cell transplantation / 中国实验血液学杂志

ABSTRACT

The study was aimed to compare the efficiency of cytomegalovirus (CMV) quantitative PCR and CMV-pp65 antigen test for detection of CMV infection and their clinical significance in patients received allogeneic hematopoietic stem cell transplantation (HSCT). 84 patients received allogeneic HSCT were enrolled in study. Anticoagulant blood samples were obtained from the recipients before and after transplantation and in the convalescence. CMV quantitative PCR and CMV-pp65 antigen test were performed weekly. The results showed that out of 84 patients, 26 cases were positive (30.95%) by CMV quantitative PCR method. Of the 26 cases, 9 cases were CMV antigenemia and 13 cases were CMV disease, the median positive time was 37.1 (7 - 105) days after HSCT. 22 cases were positive (26.19%) by CMV-pp65 antigen test method, the median positive time was 46.6 (10 - 128) days after HSCT. All the 22 positive cases detected by CMV-pp65 antigen test were also positive by CMV quantitative PCR method. Nevertheless, 4 positive cases detected by CMV quantitative PCR but negative detected by CMV-pp65 antigen test method did not develop CMV disease. The CMV disease was found in the cases either with moderate to high copies of CMV quantitative PCR or moderate to high level CMV antigenemia by CMV-pp65 antigen test method. The clearance median time was 17.5 (11 - 28) days by CMV quantitative PCR method after receiving antiviral therapy and was 10.0 (7 - 21) days by CMV-pp65 antigen detection method. It is concluded that both CMV quantitative PCR and CMV-pp65 antigen test can detect the infection of CMV early and effectively in patients received HSCT. CMV quantitative PCR is more sensitive, and CMV-pp65 is more specific. It can be more effective to guide the antiviral treatment and evaluate its efficacy when combining the two methods.