Immunoglobulin M antibodies detected by enzyme-linked immunosorbent assay and radioimmunoassay in the diagnosis of cytomegalovirus infections in pregnant women and newborn infants

Abstract

Immunoglobulin M (IgM) antibodies were detected by a commercially available enzyme-Linked Immunosorbent Assay (ELISA) in 36 of 49 (73%) pregnant women with primary cytomegalovirus (CMV) infection. A positive ELISA-IgM result occurred in 10 of 13 patients (77%) assessed within 8 weeks of seroconversion. The sensitivity of the radioimmunoassay (RIA) to identify primary infection in pregnant women was comparable, 78% in general and 86% for women tested within 16 weeks of seroconversion. Of the 36 women with primary infection who had detectable IgM antibodies by ELISA, 25 (69%) were delivered of congenitally infected infants, whereas of the 13 with undetectable IgM antibodies, 7 (54%) transmitted the infection in utero. IgM antibodies were detected by ELISA in only 5 of 43 (11%) women who experienced a recurrence of CMV which either did or did not result in congenital infection. RIA was less likely to measure CMV-specific IgM in recurrent infection, inasmuch as 1 of 19 (5.2%) women with proven recurrent infection had detectable IgM antibody, giving RIA a better specificity for primary infection. Specific IgM antibodies were detected by ELISA in 42 of 61 (69%) babies congenitally infected with CMV and in 4 of 70 (5.7%) uninfected control newborn infants. The RIA was superior for diagnosis of congenital CMV infection, with a sensitivity of 89% and a specificity of 100%. The lower sensitivity of the ELISA-IgM occurred in the category of congenitally infected infants born to mothers with recurrent infection (43%), a group that is at the lowest risk of disease or to develop sequalae. This commercially available ELISA-IgM could be used in combination with a CMV-specific IgG test for monitoring women during pregnancy for primary infection.

Laboratory signs of acute or recent cytomegalovirus infection are common in cirrhosis of the liver

“…This could be due to a persistence of IgM longer than the persistence of the virus in the blood after active CMV infection. In fact, viral DNA can persist in peripheral blood leukocytes for as long as 6 months after primary CMV infection in immunocompetent subjects [Revello et al, 1998;Zanghellini et al, 1999], whereas IgM are detectable for 30 weeks in immunocompetent subjects [Stagno et al, 1985] and even longer in immunocompromised patients [Allen et al, 1991;Eing et al, 1999]. On the other hand, in 19 IgM-negative patients with cirrhosis qPCR gave a positive result.…”

Enzyme‐linked immunoadsorbent assay for the detection of cytomegalovirus‐IgM: Comparison between eight commercial kits, immunofluorescence, and immunoblotting

“…CMV-specific IgM is a sensitive and specific indicator of primary CMV infection. In fact IgM are detected in 55-75% of sera from pregnant women undergoing primary infection and in approximately 70% of sera from congenitally infected babies (2)(3)(4).…”

A novel Western blot test containing both viral and recombinant proteins for anticytomegalovirus immunoglobulin M detection

“…Human cytomegalovirus (HCMV)-specific immunoglobulin M (IgM) is a sensitive and specific indicator of primary HCMV infection in immunocompetent subjects and is often produced during active viral reactivation in immunocompromised patients (1,4,17,19,24). Serum IgM to HCMV can be detected by a variety of different procedures, but its detection has been hampered by several technical problems causing interassay variability.…”