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首页> 外文期刊>Journal of Clinical Microbiology >Prediction of Cytomegalovirus (CMV) Plasma Load from Evaluation of CMV Whole-Blood Load in Samples from Renal Transplant Recipients
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Prediction of Cytomegalovirus (CMV) Plasma Load from Evaluation of CMV Whole-Blood Load in Samples from Renal Transplant Recipients

机译：通过评估肾移植受者样品中的巨细胞病毒全血负荷来预测巨细胞病毒（CMV）血浆负荷

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In a prospective cohort of 82 renal transplant recipients, we evaluated the capacity of the cytomegalovirus (CMV) load in whole blood (WB) to predict the plasma CMV load, aiming to identify active CMV infections by using WB samples only and to deduce a WB threshold. Using quantitative real-time PCR, a total of 1,474 WB samples were assayed, of which 279 were positive for CMV, and 140 out of the 276 paired plasma samples tested positive. Thirty (36.6%) patients presented with at least one positive plasma PCR result, and 21 infection episodes (19 patients) required curative treatment (median follow-up time, 12 months). When the plasma CMV load was >500 copies/ml (n = 70), more than 94% (95% confidence interval, 86.0%, 98.4%) of WB samples had >500 copies/ml. Two prediction models were built: log10 plasma viral load (VL) was calculated as ?0.3777 + 0.9342 × log10 WB VL and as ?0.3777 + 0.8563 × log10 WB VL for patients with and without treatment, respectively. In the validation sample (578 routine samples), 77.2% of the observed and expected plasma viral loads were concordant (95% confidence intervals, 73.5 and 80.5%). According to the model, the plasma viral load was >500 copies/ml when the WB load was >3,170 or >4,000 copies/ml in patients with or without treatment, respectively. WB seems to be an appropriate candidate for routine CMV monitoring of transplant recipients by using a single assay.
机译：在82位肾移植受者的前瞻性队列中，我们评估了全血（WB）中巨细胞病毒（CMV）负荷预测血浆CMV负荷的能力，旨在仅通过使用WB样本来鉴定活动性CMV感染并推断出WB阈。使用实时定量PCR，共检测了1,474份WB样品，其中279份为CMV阳性，而在276份配对血浆样品中有140份为阳性。 30例（36.6％）患者至少获得一项阳性血浆PCR结果，21例感染发作（19例）需要治疗（中位随访时间为12个月）。当血浆CMV载量> 500拷贝/ ml（ n = 70）时，超过94％（95％置信区间，86.0％，98.4％）的WB样品具有> 500拷贝/ ml。建立了两个预测模型：log 10 血浆病毒载量（VL）计算为？0.3777 + 0.9342×log 10 WB VL和？0.3777 + 0.8563×log 10 WB VL分别用于接受和不接受治疗的患者。在验证样本（578个常规样本）中，观察到和预期的血浆病毒载量的77.2％是一致的（95％置信区间，73.5和80.5％）。根据该模型，在接受或未接受治疗的患者中，当WB负荷> 3,170或> 4,000拷贝/ ml时，血浆病毒负荷分别> 500拷贝/ ml。通过使用单一测定，WB似乎是常规监测移植受体CMV的合适人选。

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