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1.
Clin Transplant ; 37(12): e15143, 2023 12.
Article in English | MEDLINE | ID: mdl-37805968

ABSTRACT

INTRODUCTION: Cytomegalovirus (CMV) causes significant morbidity in solid organ transplant recipients (SOTR). Measuring cell-mediated immunity (CMI) may inform the risk of CMV infection after antiviral prophylaxis and predict relapse after CMV treatment. METHODS: We serially assessed CMV CMI using the QuantiFERON-CMV assay (QF-CMV; Qiagen, Germantown, MD) in two cohorts of SOTRs: during valganciclovir prophylaxis and during treatment of CMV viremia. Results of CMI were correlated with post-prophylaxis CMV infection and post-treatment relapse, respectively. RESULTS: Only one (4.2%) of 24 CMV D+/R- patients demonstrated positive QF-CMV by the end of valganciclovir prophylaxis. Four (16.6%) patients developed post-prophylaxis CMV infection; all four had undetectable QF-CMV at end of prophylaxis. Among 20 patients treated for CMV infection, 18 (90%) developed QF-CMV levels >.2 IU/mL by end of antiviral treatment and none developed CMV relapse. In contrast, the single patient who relapsed after completing treatment had a CMV CMI <.2 IU/ml (p = .0036). CONCLUSION: Since CMV D+/R- SOTRs are unlikely to develop adequate CMV CMI while receiving valganciclovir prophylaxis, the utility of CMV CMI monitoring for risk stratification during time of prophylaxis had limited value. Conversely, CMV CMI testing may be a useful marker of the risk of CMV relapse after antiviral treatment.


Subject(s)
Cytomegalovirus Infections , Kidney Transplantation , Humans , Cytomegalovirus , Valganciclovir/therapeutic use , T-Lymphocytes , Antiviral Agents/therapeutic use , Kidney Transplantation/adverse effects , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/drug therapy , Cytomegalovirus Infections/etiology , Recurrence
2.
Diagn Microbiol Infect Dis ; 67(4): 346-9, 2010 Aug.
Article in English | MEDLINE | ID: mdl-20638602

ABSTRACT

Serologic testing for measles, mumps, rubella, and varicella (MMRV) IgG is traditionally performed by immunofluorescence assay or enzyme immunoassay (EIA). Although sensitive and specific, these methods are labor intensive, time consuming, and require separate assays for each analyte. This study evaluated the performance of the MMRV IgG AtheNA Multi-Lyte assay using nonclinically characterized serum specimens submitted to our laboratory for routine MMRV IgG testing. Mumps (n = 492) or rubella (n = 500) IgG were initially tested by enzyme-linked fluorescent antibody (ELFA), whereas measles (n = 494) or varicella (n = 497) were analyzed by EIA. Each sample was also tested by the AtheNA Multi-Lyte assay. Discordant results were retested by the predicate method and the multiplex assay, with further discrepancies being arbitrated by a third test. Compared to EIA/ELFA for MMRV IgG, the AtheNA assay demonstrated an overall agreement of 97.4%, 98.2%, 97.6%, and 100%, respectively. Use of this multiplex assay allows for the simultaneous detection of MMRV IgG, potentially decreasing cost, sample volume requirements, aliquot errors, and hands-on testing time.


Subject(s)
Antibodies/blood , Herpes Zoster/diagnosis , Immunoglobulin G/blood , Measles/diagnosis , Mumps/diagnosis , Rubella/diagnosis , Virology/methods , Herpesvirus 3, Human/immunology , Humans , Immunoassay/methods , Measles virus/immunology , Microspheres , Mumps virus/immunology , Reagent Kits, Diagnostic , Rubella virus/immunology
3.
Med Mycol ; 47(3): 336-8, 2009 May.
Article in English | MEDLINE | ID: mdl-19194818

ABSTRACT

We compared the performance of the Meridian CALAS, Wampole Crypto-LA, Murex Cryptococcus latex agglutination assay, and the Meridian Premier EIA for the detection of cryptococcal antigen in serum and CSF. The assays demonstrated similar performance characteristics based on concordance values > or = 93% but important differences were noted in endpoint titers.


Subject(s)
Antigens, Fungal/analysis , Clinical Laboratory Techniques/methods , Cryptococcosis/diagnosis , Reagent Kits, Diagnostic , Serum/chemistry , Immunoenzyme Techniques/methods , Latex Fixation Tests/methods , Sensitivity and Specificity , Serum/microbiology
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