Commercial methods for the diagnosis of CMV infection after organ or bone marrow transplantation
Utilisation des tests commercialisés pour le diagnostic d'une infection à CMV chez les greffés de moelle et d'organe
Abstract
Cytomegalovirus infection is a major problem for transplant recipients. It has been recently shown that the rate of increase in viral load correlate with CMV disease in transplant recipients. The risk is very high in persons undergoing bone marrow transplantation and in some cases preemptive therapy is used as soon as viral replication is proven. In this context the assays based on the detection of CMV in leukocytes are found to be the most sensitive. After renal transplantation a number of studies have demonstrated that the amount of CMV DNA is significantly associated with disease development. But there is no consensus with regard to the cut-off level predictive of CMV disease because of the heterogeneity of the assays used. Recent studies carried out with commercial assays detecting CMV DNA in leukocytes or plasma have shown that the performances of both are equivalent and that by using a receiver operator curve analysis a cut-off viral load can be determined which maximizes the clinical utility of these assays.