BACKGROUND: Quantitation of cytomegalovirus (CMV) DNA using real-time PCR has been utilized for monitoring CMV infection. However, the CMV antigenemia assay is still the 'gold standard' assay. There are only a few studies in Korea that compared the efficacy of use of real-time PCR for quantitation of CMV DNA in whole blood with the antigenemia assay, and most of these studies have been limited to transplant recipients. METHOD: 479 whole blood samples from 79 patients, falling under different disease groups, were tested by real-time CMV DNA PCR using the Q-CMV real-time complete kit (Nanogen Advanced Diagnostic S.r.L., Italy) and CMV antigenemia assay (CINA Kit, ArgeneBiosoft, France), and the results were compared. Repeatedly tested patients were selected and their charts were reviewed for ganciclovir therapy. RESULTS: The concordance rate of the two assays was 86.4% (Cohen's kappa coefficient value=0.659). Quantitative correlation between the two assays was a moderate (r=0.5504, P<0.0001). Among 20 patients tested repeatedly with the two assays, 13 patients were transplant recipients and treated with ganciclovir. Before treatment, CMV was detected earlier by real-time CMV DNA PCR than the antigenemia assay, with a median difference of 8 days. After treatment, the antigenemia assay achieved negative results earlier than real-time CMV DNA PCR with a median difference of 10.5 days. CONCLUSIONS: Q-CMV real-time complete kit is a useful tool for early detection of CMV infection in whole blood samples in transplant recipients.
Antiviral Agents/therapeutic use ; Cytomegalovirus/*genetics ; Cytomegalovirus Infections/drug therapy/pathology/virology ; DNA, Viral/*blood/metabolism ; Ganciclovir/therapeutic use ; Humans ; *Immunoassay ; Organ Transplantation ; Phosphoproteins/genetics/immunology/*metabolism ; *Real-Time Polymerase Chain Reaction ; Viral Matrix Proteins/genetics/immunology/*metabolism ; Virology/*methods

OBJECTIVETo explore the clinical value of determination of ATP levels in CD4(+) cells of patients with cytomegaloviral pneumonia after kidney transplantation.

METHODSTwenty-eight patients with cytomegaloviral pneumonia following kidney transplantation and 30 healthy volunteers were enrolled in this study. ATP-bioluminescence assay (ATP-CVA) was used to assess the immune response of CD4(+) cells to phytohemagglutinin (PHA) stimulation in the normal volunteers and the recipients (before and at 1, 2, and 4 weeks after renal transplantation, before and at 2 and 4 week after the treatment).

RESULTSATP concentration in CD4(+) cells of the recipients was 402-/+58 ng/ml before the operation, significantly lower than that in normal volunteers (458-/+196 ng/ml, P<0.05), and reached the lowest level in the first week after operation especially in the recipients with antibody-inducing therapy; ATP level increased slowly since week 2 post-operation, but still remained significantly lower than the preoperative by the fourth week (266-/+87 ng/ml, P<0.05), especially in the recipients receiving antibody-inducing therapy. In the event of cytomegaloviral pneumonia, ATP level underwent a mild reduction to 152-/+78 ng/ml in comparison with the postoperative level at the first week (P>0.05), and was significantly lower than preoperative level (P<0.01); the decrease was especially obvious during the exacerbation of the condition. ATP level then increased slowly after effective treatment, but was still lower than the preoperative level at 4 weeks after the operation (336-/+92 ng/ml, P<0.05).

CONCLUSIONThe determination of ATP level in CD4(+) cells allows more accurate assessment of the cellular immunity in the renal transplant recipients with cytomegaloviral pneumonia to help in the clinical treatment of the patients.

Adenosine Triphosphate ; blood ; Adult ; Aged ; CD4-Positive T-Lymphocytes ; metabolism ; Case-Control Studies ; Cytomegalovirus Infections ; immunology ; Female ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Pneumonia, Viral ; immunology ; metabolism ; virology ; Postoperative Complications ; immunology ; metabolism ; Young Adult

The study was aimed to investigate the pp65 antigen of human cytomegalovirus (CMV) and its clinical significance in patients revived allogeneic hematopoietic stem cell transplantation (HSCT). 104 patients received allogeneic HSCT were studied. Anticoagulant blood samples were obtained from the recipients before and after transplantation and in the convalescence. CMV pp65 antigen in leukocytes was detected by indirect immunofluorescence assay using CMV Brite Kit weekly. The results showed that among the 104 patients, 29 cases were CMV pp65 positive (27.88%). Out of 29 cases 16 were CMV antigenemia and 13 cases were CMV disease. There were 25 cases who positively responded to antiviral therapy (effective ratio 86.21%) and 4 cases died (case-fatality ratio 13.79%). The detection revealed a significant difference in the incidence of CMV infection between the patients received unrelated or haploidentical family donor HSCT (39.29%) and HLA-identical sibling donor HSCT (14.58%) (P < 0.05). The incidence rate of CMV infection in patients with 0-I grade aGVHD and patients with II-IV grade aGVHD were 19.44% and 46.88% respectively, which had significant difference (P < 0.05). There was significant difference in the occurrence of aGVHD between the patients with and without positive CMV pp65 (P < 0.05). It is concluded that infection of CMV can be detected by the CMV pp65 monoclonal fluorescence immunohistochemistry, The detection of CMV pp65 antigen in peripheral blood leukocytes as a indicator for CMV disease surveillance after HSCT, which may be used to early diagnose the CMV infection, to guide the antiviral treatment and evaluate its efficacy.
Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Child, Preschool ; China ; epidemiology ; Cytomegalovirus ; immunology ; Cytomegalovirus Infections ; diagnosis ; drug therapy ; epidemiology ; Female ; Graft vs Host Disease ; epidemiology ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Leukocytes ; virology ; Male ; Middle Aged ; Phosphoproteins ; blood ; Risk Factors ; Viral Matrix Proteins ; blood

Adolescent ; Antigens, Viral ; blood ; Child ; Child, Preschool ; Cytomegalovirus ; immunology ; Cytomegalovirus Infections ; diagnosis ; Female ; Flow Cytometry ; Hepatitis, Viral, Human ; diagnosis ; virology ; Humans ; Infant ; Male ; Phosphoproteins ; blood ; Viral Matrix Proteins ; blood

OBJECTIVETo explore the changes and relationship between serum soluble P-selectin, tumor necrosis factor-alpha (TNF-alpha) in coronary heart disease patients with acute coronary syndrome (ACS) and human cytomegalovirus (HCMV) infection.

METHODSThe levels of circulating soluble P-selectin, TNF-alpha, HCMV-IgM and HCMV-IgG were determined by enzyme-linked immunosorbent assay (ELISA) in 79 cases for ACS group, 30 cases for stable angina (SA) group and 30 healthy control cases.

RESULTS(1) The serum positive rate of HCMV-IgM and HCMV-IgG in the ACS, SA and healthy control groups were 30.4% (24/79), 10.0% (3/30) and 6.7% (2/30); 86.1% (68/79), 80.0% (24/30) and 53.3% (16/30), respectively. Positive rate of HCMV-IgM in the ACS was higher than those in SA and healthy control groups (P < 0.01), positive rate of HCMV-IgG in the ACS and SA groups were higher than that of the healthy control group (P < 0.01). (2) Compared with the SA group and healthy control group, the levels of the serum soluble P-selectin and TNF-alpha were significantly higher in patients with ACS [(6437.3 +/- 666.9) pg/ml vs. (1520.0 +/- 112.7) pg/ml and (1481.0 +/- 109.1) pg/ml, (56.2 +/- 18.4) pg/ml vs. (27.3 +/- 13.7) pg/ml and (28.1 +/- 11.3) pg/ml], respectively, P < 0.01). The AMI group, compared with the UA group in the ACS group, had significantly higher levels of the serum soluble P-selectin and TNF-alpha (P < 0.01). Compared with the SA group, the levels of the serum soluble P-selectin and TNF-alpha were not significantly different in healthy control group. (3) The levels of the serum soluble P-selectin and TNF-alpha in HCMV-IgM positive patients were significantly higher than the HCMV-IgM negative patients in the ACS group (P < 0.01).

CONCLUSIONThe chronic infection with HCMV might injure endothelial cells that subsequently contribute to the formation and progression of atherosclerosis, the acute infection with HCMV may induce increased serum levels of soluble P-selectin and TNF-alpha that might participate in acute coronary events.

Acute Coronary Syndrome ; blood ; virology ; Adult ; Aged ; Aged, 80 and over ; Cytomegalovirus ; immunology ; physiology ; Cytomegalovirus Infections ; blood ; virology ; Enzyme-Linked Immunosorbent Assay ; Female ; Host-Pathogen Interactions ; Humans ; Immunoglobulin M ; blood ; Male ; Middle Aged ; P-Selectin ; blood ; Tumor Necrosis Factor-alpha ; blood

Human cytomegalovirus (CMV) infection may cause life-threatening complications and lead to failure in transplantation. So, it is very important to explore the laboratory methods which can detect the CMV sufficiently early and accurately. This review discusses methodological aspects of quantitative CMV assays with emphasis on recently developed antigen detection assays and molecular biological methods.
Antigens, Viral ; blood ; Bone Marrow Transplantation ; adverse effects ; methods ; Cytomegalovirus ; immunology ; isolation & purification ; Cytomegalovirus Infections ; diagnosis ; etiology ; virology ; Humans ; Transplantation, Homologous

BACKGROUNDTo develop a capturing-ELISA for the detection of anti-HCMV-IgM antibody in serum.

METHODSThe anti-HCMV-IgM antibody was detected in 68 patients with HCMV infection by the capturing-ELISA, and the results were compared with those of indirect ELISA.

RESULTSThe specificity and sensitivity of the capturing-ELISA were shown to be significantly higher than those of indirect ELISA, and its results were not affected by RF factor.

CONCLUSIONThe capturing ELISA is specific, sensitive, convenient and reliable method which may be feasible for clinical use.

Antibodies, Viral ; blood ; Cytomegalovirus ; immunology ; Cytomegalovirus Infections ; immunology ; virology ; Enzyme-Linked Immunosorbent Assay ; methods ; Humans ; Immunoglobulin M ; blood

BACKGROUNDTo search for the serological findings and early clinical manifestations as evidences for prevention and treatment TORCH infections in pregnant women and newborns as early as possible.

METHODSELASA was performed to screen specific anti-TORCH (Toxoplasma gondii, Cytomegalovirus, Rubella virus, Herpes simplex virus) Ig-M antibodies.

RESULTSTotally 1,554 in-patients who were treated in Neonatal Intensive Care Unit (NICU) of our hospital from January 2000 to January 2003 were retrospectively studied, 48 of them had TORCH infections. Cytomegalovirus (CMV), rubella and herpes simplex virus infections accounted for 52.1%, 33.3% and 14.6%, respectively. None of them had toxoplasma infection.

CONCLUSIONTORCH infections can cause multiorgan lesions, such as hearing impairment, hyperbilirubinemias and liver dysfunction, impairment of neurologic system, myocardial impairment, thrombocytopenia, and congenital heart disease.Rubella vaccine inoculation, serological screening during pregnancy and early period of newborn, intervention and treatment in the early period are most important.

Antibodies, Viral ; blood ; immunology ; Cytomegalovirus Infections ; immunology ; Female ; Herpes Simplex ; immunology ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; immunology ; virology ; Male ; Neonatal Screening ; Retrospective Studies ; Rubella ; immunology ; Toxoplasmosis ; immunology

OBJECTIVETo investigate the pathogenic factors of human cytomegalovirus (HCMV) infections.

METHODSTotally 36 serum samples were obtained from early pregnant woman and examined with ELISA for anti-HCMV antibody IgG and IgM. After artificial abortion,chorionic villus and decidua were also examined with polymerase chain reaction (PCR) for HCMV-DNA. When the results of PCR were positive, pathological changes of these chorionic villus and decidua were analyzed.

RESULTSThe results showed that only 10 samples were PCR positive while IgG and/or IgM antibody to HCMV was positive. After infection with HCMV, different changes occurred in chorionic villus and decidual trophoblastic cells placental villus were hyperplasic and decidua cells degenerated and necrotized followed by lymphocytes infiltration.

CONCLUSIONThese pathological changes may be one of pathogenic factors of HCMV.

Adult ; Antibodies, Viral ; blood ; Chorionic Villi ; pathology ; virology ; Cytomegalovirus ; genetics ; immunology ; isolation & purification ; Cytomegalovirus Infections ; pathology ; DNA, Viral ; analysis ; Decidua ; pathology ; virology ; Female ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Pregnancy ; Pregnancy Complications, Infectious ; pathology ; virology

OBJECTIVETo further study the role of human cytomegalovirus (HCMV) infection in the pathogenesis of the type 2 diabetes mellitus.

METHODSHCMV DNA levels in sera from 29 type 2 diabetic patients and 23 controls were measured by quantitative polymerase chain reaction (PCR), and comparative analyses was made between HCMV DNA and T cell subsets, blood glucose (BG), insulin (Ins) and C peptide (C-P).

RESULTSThe levels of HCMV DNA were (1.81+/-1.67) x 10(8) copies/ml for type 2 diabetic patients, a level significantly higher than that (5.50+/-4.30) x 10(7) copies/ml of controls. The percentage of CD8 for type 2 diabetic patients with positive HCMV DNA was 29.53%+/-2.00%, being much higher than that for controls (27.13%+/-4.12%), while the ratio of CD4/CD8 1.24+/-0.05 was significantly lower than that 1.41+/-0.10 of controls. Fasting C-P of type 2 diabetic patients with positive HCMV DNA was far lower than that of those with negative HCMV DNA, but the differences of BG and Ins between the two groups were not significant.

CONCLUSIONActive HCMV infection of type 2 diabetic patients may suppress cellular immunity and its influence on the pathogenesis of the type 2 diabetes mellitus should be further studied.

Adult ; Cytomegalovirus ; genetics ; Cytomegalovirus Infections ; complications ; immunology ; DNA, Viral ; blood ; Diabetes Mellitus, Type 2 ; immunology ; virology ; Female ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; T-Lymphocyte Subsets