Prospective study of cytomegalovirus antigenemia in allograft recipients

Miller, H.; Rossier, E; Milk, Rose; Thomas, Charles A.

doi:10.1128/jcm.29.5.1054-1055.1991

Cited by 30 publications

(19 citation statements)

References 10 publications

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“…Despite a number of studies in which the CMV antigenemia assay has been shown to be a highly sensitive method for diagnosing CMV infection, there are occasional reports of failures. In a prospective study, Miller et al [16] could not demonstrate CMV antigenemia in ten transplant patients with symptomatic CMV infection. Their presumption that processing delays might have been responsible for these negative results is supported by a recent report that a delay of 6 h in the transport of blood samples to the laboratory decreased the viral antigen detection rate by at least 80 % [8].…”

Section: Discussionmentioning

confidence: 89%

Antigenemia, immunoblotting, and enzyme immunoassay for early diagnosis of cytomegalovirus infection in renal transplant patients

Fischer¹,

Rautenberg²,

Bienengräber³

et al. 1993

Transplant Int

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Timely and rapid diagnosis of cytomegalovirus (CMV) infection is important for the management of transplant patients. We compared three serological assays, IgM immunoblot and IgG/IgM enzyme immunoassay (EIA), as well as the detection of CMV antigens in polymorphonuclear blood leukocytes (antigenemia), for their value in the early diagnosis of CMV infection. Thirty-one patients were monitored longitudinally for 3 months after renal transplantation. Laboratory documented CMV infection occurred in 20 patients. All of these cases showed a positive IgM immunoblot result that was confirmed by at least one of the other test assays (IgG EIA 19/20, antigenemia assay 13/20, and IgM EIA 12/20). All of the ten patients whose clinical picture was compatible with symptomatic CMV disease were positive for CMV infection according to IgM immunoblot and IgG EIA, nine were positive according to the antigenemia assay, and seven were positive according to IgM EIA. With reference to the temporal pattern, the antigenemia assay indicated CMV infection significantly earlier than the serological tests (P < or = 0.05). In symptomatic patients CMV antigen-positive leukocytes were, on the average, detected on the day of onset of symptoms, whereas detection by IgM immunoblot, IgG EIA, and IgM EIA followed 8, 13, and 14 days later, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 89%

Antigenemia, immunoblotting, and enzyme immunoassay for early diagnosis of cytomegalovirus infection in renal transplant patients

Fischer¹,

Rautenberg²,

Bienengräber³

et al. 1993

Transplant Int

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“…Recently, the direct detection of CMV pp65 antigen in peripheral blood leukocytes was proposed as a useful marker of symptomatic CMV infection after renal transplantation [3]. However, two other groups failed to confirm these results [15,21], possibly due to some major technical drawbacks of the originally published peroxidase technique which, in our hands, led to…”

Section: Discussionmentioning

confidence: 81%

“…Miller et al [15] found no antigenemia at all in 18 actively infected transplant patients, 10 of whom showed CMV syndrome. The authors came to the conclusion that their failure to demonstrate CMV antigenemia was due to the investigation of 1-or 2-day-old specimens rather than freshly isolated blood samples.…”

Section: Discussionmentioning

confidence: 95%

“…Two other groups reported on the successful clinical use of this test [8,171. However, the assay still remains controversial as two other investigators failed to confirm those results [15,21]. We recently published an improved protocol that was based on the alkaline phosphatase-anti-alkaline phosphatase (APAAP) technique and that overcame the interpretation problems of the original technique [2].…”

Section: Introductionmentioning

confidence: 99%

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A longitudinal prospective study of cytomegalovirus pp65 antigenemia in renal transplant recipients

Bein¹,

Bitsch²,

Hoyer³

et al. 1993

Transplant Int

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Cytomegalovirus (CMV)-encoded pp65 antigen in peripheral blood leukocytes (CMV antigenemia) was investigated in 1017 serial samples from 64 patients for 16 weeks after renal transplantation in a prospective study. In 110 samples from 24 patients, at least one antigen-positive leukocyte was identified. The median number of stained cells was 4 (range 1-1000) per 4 x 10(5) leukocytes. Twenty-one of 24 patients with serological signs of an active CMV infection were antigen-positive (sensitivity 87.5%), whereas 3 patients with antigenemia did not show serological signs of infection during the observation period (specificity 92.5%). Positive results were obtained 19 days (median) before serological response and 9 days (median) before the onset of CMV syndrome. The sensitivity in defining a CMV syndrome was 100% (n = 8). In all patients who presented with CMV syndrome, antigenemia was present prior to the onset of symptoms or on the same day. In contrast, serological monitoring rendered the diagnosis of CMV infection possible at the onset of clinical symptoms in only two of eight patients. We conclude that (1) insufficient results obtained with the CMV antigenemia assay by other investigators are mainly due to technical problems that can easily be overcome by the protocol presented and (2) the detection of CMV pp65 antigen in peripheral blood leukocytes is an excellent tool for rapid and early diagnosis of CMV infection.

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“…Monitoring cytomegalovirus (CMV) antigenemia in patients who are immunocompromised because of organ transplantation or AIDS has been reported to be a useful marker of disease progression and treatment efficacy (2,3,7,9,10,(17)(18)(19)(20)(21). Although the antigenemia assay (AA) is very sensitive for detection of CMV, delays of as little as 6 h in transporting and processing specimens have been reported to reduce antigen detection rates as much as 80% (1).…”

mentioning

confidence: 99%

Comparison of culture and the antigenemia assay for detection of cytomegalovirus in blood specimens submitted to a reference laboratory

et al. 1997

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We compared the antigenemia assay (AA) with tandem shell vial cultures (SVCs) and tube cultures (TCs) for detection of cytomegalovirus (CMV) in 343 blood specimens. For 249 specimens, the AA was performed in duplicate with two different commercially available monoclonal antibody reagents (Biotest Diagnostic Corporation and Argene Biosoft). Specimens considered true positives were positive in either culture system or both AAs. Only specimens which were negative in both cultures and positive in a single AA were tested retrospectively with a CMV PCR assay. CMV recovery rates were also calculated to determine if increased specimen age resulted in decreased positivity. CMV recovery rates for the AA and the combination of both cultures were 20.0 and 5.0% at 3 to 18 h, 20.2 and 14.0% at 18 to 35 h, 12.5 and 7.8% at 36 to 52 h, and 18.8 and 6.3% at 64 to 75 h, respectively. The sensitivities and specificities of the Biotest AA, the Argene AA, SVC, and TC were 84.4 and 100.0, 100.0 and 99.6, 44.4 and 100.0, and 46.0 and 100.0%, respectively. The AA was significantly more sensitive than either culture method alone and was also more sensitive than the two culture methods used in tandem (the tandem culture sensitivity was 63.5%); the Argene AA identified more positives than the Biotest AA.

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Prospective study of cytomegalovirus antigenemia in allograft recipients

Cited by 30 publications

References 10 publications

Antigenemia, immunoblotting, and enzyme immunoassay for early diagnosis of cytomegalovirus infection in renal transplant patients

Antigenemia, immunoblotting, and enzyme immunoassay for early diagnosis of cytomegalovirus infection in renal transplant patients

A longitudinal prospective study of cytomegalovirus pp65 antigenemia in renal transplant recipients

Comparison of culture and the antigenemia assay for detection of cytomegalovirus in blood specimens submitted to a reference laboratory

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