Comparison of serological assay and polymerase chain reaction for the monitoring of acute and chronic cytomegalovirus infections

doi:10.3969/j.issn.1673-8640.2016.06.005

Abstract

Abstract:

Objective To compare serological assay（chemiluminescence immunoassay） in cytomegalovirus（CMV） antibody determination and real-time fluorescence polymerase chain reaction（PCR） in qualitative CMV DNA determination for the monitoring of acute and chronic CMV infections. Methods A total of 361 patients suspected with CMV infections were analyzed retrospectively. Patients suspected with CMV infections were determined on the bases of nonspecific symptoms,including fever,leukopenia,hyperbilirubinemia and alanine aminotransferase elevation,alone or in combination. All patients were screened for CMV IgM and IgG antibodies and CMV DNA. Results CMV IgM antibody and CMV DNA by the 2 methods were all positive in only 7 patients. A total of 13 patients were positive for CMV IgM antibody and negative for CMV DNA,23 patients were positive for CMV DNA and negative for CMV IgM antibody. There was no consistency between the 2 methods（Kappa=0.229,P<0.05）. Furthermore,327 patients with positive CMV IgG antibody were classified into CMV DNA negative group（300 cases） and CMV DNA positive group（27 cases） according to CMV DNA determination results,and there was no statistical significance for CMV IgG antibody level [medians（quartiles） were 195.24（73.80,250.00） and 221.90（129.60,250.00） AU/mL,P=0.137]. Conclusions Having poor consistency with CMV DNA determination results,serological assay for CMV antibodies is not sensitive enough to diagnose acute CMV infection and cannot be used for monitoring CMV infections during the chronic period. The clinical diagnosis of CMV infections should be evaluated by the combination determination of CMV DNA and CMV antibodies,including the quantitation of CMV IgG.

Key words: Cytomegalovirus, Serological assay, Polymerase chain reaction

CLC Number:

R446.61

CHEN Yanwen, HU Yao. Comparison of serological assay and polymerase chain reaction for the monitoring of acute and chronic cytomegalovirus infections[J]. Laboratory Medicine, 2016, 31(6): 458-461.

Figures/Tables 2

References 19

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血清学检测	PCR		合计
血清学检测	CMV DNA 阳性	CMV DNA 阴性	合计
CMV IgM 阳性	7	13	20
CMV IgM 阴性	23	318	341
合计	30	331	361

血清学检测	PCR		合计
血清学检测	CMV DNA 阳性	CMV DNA 阴性	合计
CMV IgM 阳性	7	13	20
CMV IgM 阴性	23	318	341
合计	30	331	361

组别	CMV IgG
组别	阳性（例）	定量（AU / mL）
CMV DNA 阳性组	27	221.90（129.60,250.00）
CMV DNA 阴性组	300	195.24（73.80,250.00）

组别	CMV IgG
组别	阳性（例）	定量（AU / mL）
CMV DNA 阳性组	27	221.90（129.60,250.00）
CMV DNA 阴性组	300	195.24（73.80,250.00）