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首页> 外文期刊>Journal of Clinical Microbiology >Validation of Clinical Application of Cytomegalovirus Plasma DNA Load Measurement and Definition of Treatment Criteria by Analysis of Correlation to Antigen Detection
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Validation of Clinical Application of Cytomegalovirus Plasma DNA Load Measurement and Definition of Treatment Criteria by Analysis of Correlation to Antigen Detection

机译：通过与抗原检测的相关性分析验证巨细胞病毒血浆DNA负荷测量的临床应用和治疗标准的确定

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Successful preemptive cytomegalovirus (CMV) therapy in transplant patients depends on the availability of sensitive, specific, and timely diagnostic tests for CMV infections. The pp65 antigenemia assay has been used for this purpose with considerable success. Quantification of CMV DNA is currently regarded to be an alternative diagnostic approach. The precise relationship between these two methods has still to be defined, but is essential to compare diagnostic results. This study compared the results of both assays with a large series of transplant recipients in different categories. An internally controlled quantitative real-time CMV DNA PCR was used to test 409 plasma samples from solid organ transplant (SOT) and stem cell transplant (SCT) patients. Levels of CMV DNA in plasma correlated well with classified outcomes of the pp65 antigenemia test. Despite this correlation, the quantitative CMV PCR values in a class of antigen test results were within a wide range, and the definition of an optimal cutoff value for initiating treatment required further analysis by a receiver-operating characteristic curve analysis. This is essential for reactivating infections in particular. For the SCT patients the optimal cutoff value of CMV DNA load defining relevant viral reactivation (in this assay, 10,000 copies/ml) was slightly higher than that for the SOT patients (6,300 copies/ml). Based on a comparison with the established pp65 antigenemia assay, quantification of CMV DNA in plasma appeared to be capable of guiding the clinical management of transplant recipients. This approach may have important advantages, which include a superior reproducibility and sensitivity, allowing the inclusion of kinetic criteria in clinical guidelines.
机译：在移植患者中成功的先发制人巨细胞病毒（CMV）治疗能否成功取决于对CMV感染进行灵敏，特异和及时的诊断测试。 pp65抗原血症检测已成功用于此目的。 CMV DNA的定量目前被认为是另一种诊断方法。这两种方法之间的精确关系仍有待确定，但对于比较诊断结果至关重要。这项研究将两种测定的结果与一系列不同类别的移植接受者进行了比较。内部控制的定量实时CMV DNA PCR用于检测来自实体器官移植（SOT）和干细胞移植（SCT）患者的409个血浆样品。血浆中CMV DNA的水平与pp65抗原血症测试的分类结果密切相关。尽管存在这种相关性，但一类抗原测试结果中的定量CMV PCR值仍在很宽的范围内，并且需要通过接受者操作的特征曲线分析进一步分析确定起始治疗的最佳临界值。这对于重新激活感染至关重要。对于SCT患者，定义相关病毒再激活的CMV DNA负荷的最佳临界值（在此测定中为10,000拷贝/ ml）略高于SOT患者（6,300拷贝/ ml）。根据与已建立的pp65抗原血症测定法的比较，血浆中CMV DNA的定量似乎能够指导移植受者的临床管理。这种方法可能具有重要的优势，其中包括优异的重现性和敏感性，可以将动力学标准纳入临床指南。

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