Quantitative Analysis of Cytomegalovirus (CMV) Viremia Using the pp65 Antigenemia Assay and the COBAS AMPLICOR CMV MONITOR PCR Test after Blood and Marrow Allogeneic Transplantation

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Journal of Clinical Microbiology, December 2000, p. 4356-4360, Vol. 38, No. 12
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Quantitative Analysis of Cytomegalovirus (CMV) Viremia Using the pp65 Antigenemia Assay and the COBAS AMPLICOR CMV MONITOR PCR Test after Blood and Marrow Allogeneic Transplantation

G. Boivin,¹^,^* R. Bélanger,² R. Delage,³ C. Béliveau,⁴ C. Demers,³ N. Goyette,¹ and J. Roy²

Research Center in Infectious Diseases of the Centre Hospitalier Universitaire de Québec and Department of Medical Biology¹ and Bone Marrow Transplant Unit, St-Sacrement Hospital and Department of Medicine,³ Université Laval, Québec, and Department of Microbiology⁴ and Bone Marrow Transplant Unit,² Maisonneuve-Rosemont Hospital and Department of Medicine, Université de Montréal, Montréal, Québec, Canada

Received 23 June 2000/Returned for modification 28 July 2000/Accepted 26 September 2000

The performance of a commercially available qualitative PCR test for plasma (AMPLICOR CMV Test; Roche Diagnostics) and a quantitativePCR test for plasma and leukocytes (COBAS AMPLICOR CMV MONITORTest; Roche Diagnostics) was evaluated with samples from 50 bloodor marrow allogeneic transplant recipients who received shortcourses of sequential ganciclovir therapy (2 weeks intravenouslyfollowed by 2 weeks orally) based on a positive cytomegalovirus(CMV) pp65 antigenemia (AG) assay. The number of persons witha positive CMV test was significantly higher for leukocyte-basedassays (AG, 67.5%; PCR, 62.5%) compared to both quantitative andqualitative PCR tests of plasma (42.5 and 35%, respectively).One person developed CMV disease during the study despite a negativeAG assay; in this particular case, all PCR assays were found tobe positive 10 days before his death. There was a trend for earlierpositivity after transplantation and more rapid negativity afterinitiation of ganciclovir for the tests performed on leukocytes.The mean number of CMV copies as assessed by PCR was significantlyhigher in leukocytes than in plasma (P = 0.02). Overall, excellentagreement (kappa coefficient, >0.75) was found only between thetwo PCR assays (qualitative and quantitative) based on plasma.These results suggest that either the pp65 AG assay or the COBASAMPLICOR CMV MONITOR Test using leukocytes could be used to safelymonitor CMV viremia in related allogeneic blood or marrow transplantrecipients. Such a strategy will result in preemptive treatmentfor about two-thirds of the persons with a relatively low rate(<33%) of secondary viremic episodes following short courses ofganciclovirtherapy.

^* Corresponding author. Mailing address: CHUQ-CHUL, Room RC-709, 2705 Blvd. Laurier, Sainte-Foy, Québec, Canada G1V 4G2. Phone:(418) 654-2705. Fax: (418) 654-2715. E-mail: Guy.Boivin{at}crchul.ulaval.ca.

Journal of Clinical Microbiology, December 2000, p. 4356-4360, Vol. 38, No. 12
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

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