Cytomegalovirus infection in renal transplant recipients diagnosed by nested-PCR

Abstract

A prospective study of cytomegalovirus (CMV) infection was carried out on 34 renal transplant recipients managed at a General Hospital in Ribeirão Preto, SP, Brazil. Serologic tests showed that all patients were infected with CMV before renal transplantation. Two nested-PCR techniques with primers that recognize sequences of the glycoprotein B (gB) and H (gH) genes were used for CMV detection in blood and urine samples during the post-transplantation period. CMV was detected more frequently in blood samples than in urine samples (P<0.001). Thirty-three patients had CMV detected at least once in blood and/or urine samples. Seven of these patients (21.2%) were diagnosed as having symptomatic CMV infection and showed a worse clinical outcome, with a higher death rate (P = 0.03). No association between CMV viremia and graft rejection was observed. Nested-PCR was not useful to identify patients at risk for symptomatic CMV infection since only 21.2% of the patients with CMV infection were symptomatic.

Monitoring for human cytomegalovirus infection in solid organ transplant recipients through antigenemia and glycoprotein N (gN) variants: evidence of correlation and potential prognostic value of gN genotypes

“…Qualitative nested-PCR on DNA extracted from circulating leukocytes showed a high sensitivity and specificity, although some reports showed a limited capacity to distinguish between replicating and latent virus [7,38]. This assay is very useful for the early diagnosis of infection in patients at high risk of developing HCMV disease [35,39].…”

The use of qualitative and quantitative polymerase chain reactions for diagnosis of cytomegalovirus infections in bone marrow and kidney transplant recipients

“…These sensitivity and specificity rates are higher than those reported for CMV serologic tests 25 . The CMV genome detection by qualitative PCR followed by confirmatory nested-PCR with gB primers, processing urine and blood samples of kidney transplant patients, was able to detect 94.3% of active CMV infections during a 3 to 10-month follow-up period 2 . In the present study, CMV qualitative and semi-quantitative PCRs were performed using DNA extracts from PBL.…”

Cytomegalovirus Infection in Liver Transplantation

“…With age the increased prevalence of antibodies is common. This may not depend on the geographical area, but the socio-economic status may be important [10,[23][24][25][26][27][28]. The seroprevalence of CMV in populations at high socioeconomic level varies from 40% to 60%, increases after infection of early childhood and approximately 10% to 20% of children have their first infection episode before puberty [10].…”

“…In lower socioeconomic populations the seroprevalence level is higher, ranging from 80% to 100%. In Brazil, seroprevalence of cytomegalovirus averages 90% in adult populations [28].…”

“…The clinical course of CMV in immunocompetent individuals may be asymptomatic or may resemble "Mononucleosis Syndrome" presented by persistent fever, myalgia, pharyngitis, lymphadenopathy, sweating and hepatosplenomegaly [10,[28][29][30][31][32][33][34].…”