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Journal of Clinical Microbiology, September 1999, p. 2804-2807, Vol. 37, No. 9
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Use of Molecular Assays in Diagnosis and Monitoring of Cytomegalovirus Disease following Renal Transplantation

Celia Aitken,1,* Winsome Barrett-Muir,1 Colin Millar,2 Kate Templeton,1 Janice Thomas,2 Fran Sheridan,4 Donald Jeffries,1 Magdi Yaqoob,2 and Judith Breuer1

Departments of Virology,1 Renal Medicine,2 and Computer Services,3 The Royal Hospitals NHS Trust, West Smithfield, London EC1 7BE, and Murex Diagnostics, Dartford,4 United Kingdom

Received 12 February 1999/Returned for modification 16 March 1999/Accepted 25 May 1999

We compared two commercial molecular assays (the Murex Hybrid Capture CMV DNA assay [HCA], version 2, and the Roche Amplicor plasma PCR assay) with a standard shell vial assay in detecting and predicting cytomegalovirus (CMV) disease in a group of renal transplant patients and assessed the role of viral load measurements (using the HCA) in their management. The sensitivity of the HCA and Amplicor assay in terms of disease detection was 100%, compared to 71% for the shell vial assay. Both the HCA and the PCR assay detected all cases of disease, at medians of 11 and 12.5 days before the onset of symptoms, respectively. Significantly higher viral loads were detected in those patients with symptoms (7.9 × 105 copies/ml) than in patients without symptoms (7.9 × 104 copies/ml; P < 0.0001). There was also a trend towards higher viral loads in those patients with primary infections (7.8 × 105 copies/ml) than in those patients with reactivations of CMV disease or reinfections. Successful treatment with ganciclovir was associated with a >90% reduction in viral load. Both of these new assays are sensitive and easy to use. A comparison of accurate quantitation is also useful in monitoring responses to antiviral therapy.

* Corresponding author. Mailing address: Department of Virology, St. Bartholomew's Hospital, West Smithfield, London EC1 7BE, United Kingdom. Phone: 0171 601 7352. Fax: 0171 726 4248. E-mail: c.aitken{at}mds.qmw.ac.uk.

Journal of Clinical Microbiology, September 1999, p. 2804-2807, Vol. 37, No. 9
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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