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Licensed Unlicensed Requires Authentication Published by De Gruyter February 1, 2009

Methodology for monitoring cytomegalovirus infection after renal transplantation

  • Wujun Xue , Hua Liu , Hang Yan , Puxun Tian , Xiaoming Ding , Xiaoming Pan , Xinshun Feng , Heli Xiang , Jun Hou and Xiaoli He

Abstract

Background: The aim of this study was to evaluate the diagnostic value of different detection methods for cytomegalovirus (CMV) infection after renal transplantation and also to establish a system to monitor therapy for CMV infection.

Methods: We retrospectively studied 1516 renal transplant recipients from June 1994 to December 2006. All patients were screened for CMV-DNA. A total of 1402 patients had received CMV-IgG/IgM detection since June 1996 and 660 had received CMV antigen detection since June 2000.

Results: A total of 664 (43.8%) recipients developed CMV infection. The sensitivity, specificity and Youden index of the three methods, respectively, were 18.84%, 100% and 0.1884 for ELISA, 91.86%, 82.98% and 0.7484 for PCR, and 88.06%, 96.95% and 0.8501 for the CMV-pp65 antigenemia test. The sensitivity and specificity of the two combined detection methods (CMV-DNA and CMV-pp65) for post-operation CMV infection were 93.49% and 99.06%; the two detection methods had significant dependability (p<0.05) in diagnosis of CMV infection and in evaluation of therapeutic effect of antiviral drugs.

Conclusions: Only ELISA can be used as a screening index in order to distinguish whether the donors or recipients are infected with CMV or not. CMV-pp65 antigenemia can help guide clinical therapy for CMV infection. CMV-pp65 and CMV-PCR combined together provide a more effective method to monitor CMV infection and predict its outcome.

Clin Chem Lab Med 2009;47:177–81.


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Wujun Xue, Hua Liu and Hang Yan contributed equally to this work.

Corresponding author: Wujun Xue, Department of Renal Transplantation, the First Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi 710061, China Phone: +86-29-85323955, Fax: +86-29-85323718,

Received: 2008-7-12
Accepted: 2008-11-6
Published Online: 2009-02-01
Published in Print: 2009-02-01

©2009 by Walter de Gruyter Berlin New York

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