Quantification of cytomegalovirus DNA levels in intestinal biopsies as a diagnostic tool for CMV intestinal disease

Symptomatic cytomegalovirus gastrointestinal infection with positive quantitative real-time PCR findings in apparently immunocompetent patients: a case series

“…Even if histopathologic testing cannot be replaced quantification of CMV-224 DNA in intestinal biopsy by rtPCR is a useful diagnostic tool with high sensitivity, this method is 225 objective, fast and highly standardized. In cases of negative histopathological results, CMV 226 associated disease should be diagnosed on clinical grounds (symptoms, endoscopic lesions, 227 absence of other pathogens) in combination with detection of virus by quantitative rtPCR [11]. As in previous study, CMV DNA load in blood was negative for 75% patients (n=4) suggesting a 233 localized replication in the digestive tract only [26,27].…”

“…One work aimed to 214 interpret CMV DNA quantification in 163 lower intestinal biopsy from immunocompromised 215 patients. Results of this study supposed that histopathology alone was not enough sensitive as 216 suitable gold standard [11]. Therefore Ganzenmueller et al established cut-off intestinal CMV 217 DNA load predictive for CMV intestinal disease by using histopathological or clinical criteria as 218 gold standard to attribute intestinal illness to CMV.…”

High intrahepatic HHV-6 virus loads but neither CMV nor EBV are associated with decreased graft survival after diagnosis of graft hepatitis

“…For example, quantitation of CMV DNA in colon biopsies has been established recently and high CMV DNA concentrations were predictive of CMV intestinal disease (e.g. colitis) [15].…”

Cytomegalovirus quantification: Where to next in optimising patient management?

“…The average viral load needed to "see" HCMV inclusion is ∼5 × 10 6 genomes/150,000 cell equivalents 50 whereas with sensitive quantitative PCR approaches lower loads can frequently be detected that are associated with organ malfunction and so challenging the perception that without evidence of inclusions or immunohistochemical staining of HCMV antigens HCMV is not contributing to pathology. 51,52 The availability of successful antiviral drugs against HCMV in the form of aciclovir and ganciclovir and their pro-drugs valaciclovir and valganciclovir has led to their deployment in a range of clinical settings. In the context of solid organ transplantation two modes of patient management have been adopted -pre-emptive therapy (where markers of HCMV replication trigger antiviral intervention) and prophylaxis (where the drugs are given from transplantation for a defined duration to cover the risk period for HCMV disease (usually 100-200 days) as reviewed by Razonable in 2010.…”