Clinical utility of CMV early and late transcript detection with NASBA in bronchoalveolar lavages

Keightley, Maria-Cristina; Rinaldo, Charles R.; Bullotta, Arlene; Dauber, James H.; George, Kirsten St.

doi:10.1016/j.jcv.2006.08.010

Cited by 9 publications

(3 citation statements)

References 50 publications

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“…The method is standardized but the mRNA extraction procedure is time consuming. Published reports suggest the use of mRNA transcripts of late CMV genes for reliable prognosis [46]. Experience with NASBA in transplant, AIDS and SOT patients has been encouraging [47].…”

Section: Diagnostic Methods For CMVmentioning

confidence: 99%

Overview of the Diagnosis of Cytomegalovirus Infection

Ross¹,

Novák²,

Pati³

et al. 2011

IDDT

212

177

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Cytomegalovirus (CMV) is recognized as the most common congenital viral infection in humans and an important cause of morbidity and mortality in immunocompromised hosts. This recognition of the clinical importance of invasive CMV disease in the setting of immunodeficiency and in children with congenital CMV infection has led to the development of new diagnostic procedures for the rapid identification of immunocompromised individuals with CMV disease, as well as fetuses and infants with congenital infection. Diagnosis of acute maternal CMV infection by the presence of IgM and low IgG avidity requires confirmation of fetal infection which is typically performed by CMV PCR of the amniotic fluid. Viral culture of the urine and saliva obtained within the first two weeks of life continue to be the gold standard for diagnosis of congenitally infected infants. PCR assays of dried blood spots from infants have not been shown to have sufficient sensitivity for the identification of most infants with congenital CMV infection. However, saliva PCR assays are currently being assessed as a useful screening method for congenital CMV infection. In the immunocompromised host, newer rapid diagnostic assays such as pp65 antigenemia and real-time CMV PCR of blood or plasma have allowed for preemptive treatment reducing morbidity and mortality. However, lack of standardized real-time PCR protocols hinders the comparison of the data across different centers and the development of uniform guidelines for the management of invasive CMV infections in immunocompromised individuals.

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Section: Diagnostic Methods For CMVmentioning

confidence: 99%

Overview of the Diagnosis of Cytomegalovirus Infection

Ross¹,

Novák²,

Pati³

et al. 2011

IDDT

212

177

View full text Add to dashboard Cite

show abstract

“…Early studies showed the superior sensitivity of molecular methods in detecting the presence of CMV . Although measurement of plasma CMV levels by PCR has been shown to be predictive of disease development in some transplant populations , studies have conflicted as to the clinical utility of measuring quantitative viral loads present in bronchoalveolar lavage (BAL) specimens from lung transplant recipients .…”

mentioning

confidence: 99%

Cytomegalovirus disease and infection in lung transplant recipients in the setting of planned indefinite valganciclovir prophylaxis

Wiita

Roubinian

Khan

et al. 2012

Transplant Infectious Dis

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BACKGROUND:The use of crossmatch-compatible platelets (PLTs) improves posttransfusion corrected count increments (CCIs) in patients with alloimmune PLT refractoriness. However, few reports address the efficacy of utilizing this strategy for patients requiring intensive PLT transfusion therapy lasting several weeks to months. STUDY DESIGN AND METHODS: Medical records of patients with two or more PLT crossmatch assays performed between 2002 and 2010 were reviewed. All patients were refractory to random single-donor apheresis PLT units, defined as two consecutive 1-hour posttransfusion CCIs of less than 7500. A commercial solid-phase adherence assay was used for crossmatching. RESULTS: Seventy-one patients were included. A median of four crossmatch assays were performed per patient (range, 2-17). Mean percent reactivity in initial (58.6%) versus last (55.3%) crossmatch assay for each patient demonstrated no trend toward progressive alloimmunization (p = NS). A total of 738 crossmatched PLT units were administered with a mean Ϯ standard deviation CCI of 7000 Ϯ 7900 (n = 443 units with adequate 1-hr posttransfusion counts), a significant improvement over random PLTs (p < 0.001). Patients with an initial crossmatch reactivity of greater than 66% were significantly more likely to demonstrate at least one panreactive crossmatch assay, impacting the availability of compatible PLTs for optimum transfusion support. One patient (1.4%) developed WHO Grade IV bleeding. CONCLUSIONS: Progressive alloimmunization to mismatched antigens does not impact medium-term transfusion support with crossmatched PLTs. Increased reactivity in the initial crossmatch assay can serve as a trigger to initiate workup for HLA-matched PLTs as a second-line approach. However, for most patients, medium-term transfusion support with crossmatched PLTs offers an effective and rapid first-line approach to management of PLT transfusion refractoriness.

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“…This test detects the HCMV pp67 mRNA in whole blood extracts. In addition to the detection of pp67, which is produced late in the replication cycle, the detection of IE mRNA, NASBA technology has been described [66]. Although specificity was described to be high, sensitivity of the mRNA detection was too low (20-76%) to make it a useful tool for preemptive management and diagnosis of HCMV disease [50,[66][67][68].…”

Section: Hcmv Rna Detectionmentioning

confidence: 99%

Recent developments in human cytomegalovirus diagnosis

Halwachs‐Baumann¹

2007

Expert Review of Anti-infective Therapy

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Since the early 1990s, great efforts have been made in the field of human cytomegalovirus (HCMV) diagnosis. Besides HCMV diagnosis in immunosuppressed patients (solid organ transplant recipients, hematopoietic stem cell transplant patients and AIDS patients), diagnosis in connection with congenital HCMV infection is of great interest. This review focuses on the development and clinical utility of serological assays, as well as on virological tests (molecular and nonmolecular assays). Interpretation of these tests is strongly dependent on the patient group (solid organ transplant recipients and hematopoietic stem cell transplant patients) and whether the tests are used for screening, risk stratification or diagnosis. Furthermore, a better understanding of HCMV infection has led to new approaches in HCMV diagnosis and monitoring. Thus, assays for viral resistance testing and assays for monitoring the HCMV-specific cellular immune response are increasingly important for the guidance of antiviral therapy.

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Clinical utility of CMV early and late transcript detection with NASBA in bronchoalveolar lavages

Cited by 9 publications

References 50 publications

Overview of the Diagnosis of Cytomegalovirus Infection

Overview of the Diagnosis of Cytomegalovirus Infection

Cytomegalovirus disease and infection in lung transplant recipients in the setting of planned indefinite valganciclovir prophylaxis

Recent developments in human cytomegalovirus diagnosis

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