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Journal of Clinical Microbiology, May 1998, p. 1341-1346, Vol. 36, No. 5
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Diagnostic Value of Monitoring Human Cytomegalovirus Late pp67 mRNA Expression in Renal-Allograft Recipients by Nucleic Acid Sequence-Based Amplification

Marinus J. Blok,1,* Valere J. Goossens,1 Sabina J. V. Vanherle,1 Bert Top,2 Nicole Tacken,2 Jaap M. Middeldorp,2 Maarten H. L. Christiaans,3 Johannes P. van Hooff,3 and Cathrien A. Bruggeman1

Departments of Medical Microbiology1 and Internal Medicine,3 University Hospital Maastricht, 6202 AZ Maastricht, and Organon Teknika B.V., 5280 AB Boxtel,2 The Netherlands

Received 17 October 1997/Returned for modification 14 January 1998/Accepted 19 February 1998

The diagnostic value of monitoring human cytomegalovirus (HCMV) late pp67 mRNA expression by nucleic acid sequence-based amplification (NASBA) after renal-allograft transplantation was evaluated. RNAs were isolated from 489 whole-blood specimens of 42 patients for the specific amplification of the late pp67 (UL65) mRNA. NASBA results were compared to results from the pp65 antigenemia assay, virus isolation by cell culture, and serology. The sensitivity value for NASBA proved to be higher than that for the antigenemia assay (50 versus 35%) for the detection of HCMV infection, while the sensitivity values of cell culture and NASBA were comparable (54 and 50%, respectively). NASBA detected the onset of HCMV infection simultaneously with cell culture and the antigenemia assay. Both the antigenemia assay and NASBA are very specific (100%) and highly predictive (100%) for the onset of HCMV infection. Antiviral therapy with ganciclovir resulted in negative results for cell culture, the antigenemia assay, and NASBA. In conclusion, monitoring HCMV pp67 mRNA expression by NASBA is a highly specific method for the detection of HCMV infection in renal-allograft recipients and is more sensitive than the antigenemia assay. Furthermore, NASBA can be used to monitor the progression of HCMV infections and the effect of antiviral therapy on viral activity.

* Corresponding author. Mailing address: Department of Medical Microbiology, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Phone: 31 43 38 74 644. Fax: 31 43 38 76 643. E-mail: mbl{at}lmib.azm.nl.

Journal of Clinical Microbiology, May 1998, p. 1341-1346, Vol. 36, No. 5
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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