Preliminary report for the application of nucleic acid sequence-based amplification in detection of human cytomegalovirus (HCMV) late pp67 mRNA for diagnosis of HCMV infection.

Human cytomegalovirus (HCMV) late pp67 mRNA expression by nucleic acid sequence-based amplification (NASBA) in patients, clinically diagnosed as possible HCMV, probable HCMV disease, and no disease, was evaluated. The RNAs were isolated from 11 whole-blood samples of 11 patients for the specific amplification of the pp67 mRNA. NASBA results were compared to results from PCR assay and serological assay. The HCMV pp67 mRNA could be found in 3 of 11 patients, whereas, HCMV-DNA PCR was positive in 6 of 11 patients. PCR assay for HCMV-DNA in plasma has proved to correlate with clinical diagnosis of HCMV infection. Only 2 patient samples of NASBA positive results coincided with HCMV-DNA PCR. However, the diagnosis of clinically relevant HCMV infection by NASBA was seen. Anti-CMV IgG titers of 1:1,600 or over 1:1,600 were found in 2 of 3 NASBA positive cases and 5 of 6 HCMV-DNA positive cases, whereas, anti-CMV IgM were all negative. These results showed the correlation of HCMV infection detected by NASBA, PCR assay and anti-CMV IgG of the titers up to 1:1,600. Additionally, a low antibody titer of the HIV patient could be diagnosed by NASBA or PCR. In conclusion, pp67 mRNA NASBA appears to be a promising diagnostic tool in analysis of HCMV infection and/or disease. Its diagnostic value should be defined in the specific group for the follow-up of immunocompromised patients, such as organ transplant recipients in future prospective studies.

Plasma HIV-1 RNA viral load and serum vitamin A and E levels in HIV-1 infected pregnant women.

The aim of this study was to assess the correlation between plasma HIV-1 RNA viral load and serum vitamin A and E concentrations and vitamin E/cholesterol ratio in HIV-1 infected pregnant women not receiving antiretroviral therapy There were no significant correlations between plasma HIV-1 RNA viral load and serum vitamin A and E concentrations and vitamin E/cholesterol ratio. However, the presence of underlying vitamin A deficiency in these pregnant women was common.

Maternal viral load and vertical transmission of HIV-1 in mid-trimester gestation.

BACKGROUND: It is now accepted that the majority of HIV-1 vertical transmissions occur in late gestation and at the time of delivery. However, there is wide variation in the prevalence rate of mid-trimester vertical transmission. We assessed the maternal HIV-1 RNA viral load and in utero transmission during mid-trimester gestation. METHODS: Patients were enrolled when they decided to have their pregnancies terminated between 17 and 24 weeks of gestation. Prostaglandin-induced abortion with PGE1 analogue vaginal administration was carried out in all patients. Maternal plasma HIV-1 RNA viral load and plasma HIV-1 RNA (qualitative) from abortus heart blood were assessed. RESULTS: Amongst 41 HIV-1 seropositive pregnant women not receiving antiretroviral therapy plasma HIV-1 RNA was detected in the abortus heart blood from two women (4.9%; 95% confidence interval (CI), 0.6-16.5). Transmission occurred in one out of nine (11.1%; 95% CI, 0.3-48.2) with maternal viral load > or =100000 copies/ml versus one out of 32 (3.1%; 95% CI, 0.1-16.2) of those with <100000 copies/ml (P = 0.39). CONCLUSIONS: The frequency of HIV-1 vertical transmission during mid-trimester was approximately 5% as detected by plasma HIV-1 RNA (qualitative) method in the fetuses aborted from the prostaglandin termination of pregnancy. During mid-trimester gestation there was no correlation between high maternal viral load and vertical transmission.