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Journal of Clinical Microbiology, February 2000, p. 727-732, Vol. 38, No. 2
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Comparison of Three Assays for Cytomegalovirus Detection in AIDS Patients at Risk for Retinitis

Pornthep Wattanamano,1 John L. Clayton,2 Jeffrey J. Kopicko,2 Patricia Kissinger,2 Steven Elliot,1 Christine Jarrott,3 Setlur Rangan,1 and Mark A. Beilke1,*

Section of Infectious Diseases1 and General Clinical Research Center Branch,3 Department of Medicine, Tulane University School of Medicine, and Tulane University School of Public Health and Tropical Medicine,2 New Orleans, Louisiana 70112

Received 29 June 1999/Returned for modification 23 August 1999/Accepted 4 November 1999

The purpose of this study was to determine the sensitivity and specificity of three different methods of cytomegalovirus (CMV) detection for AIDS patients at risk for CMV retinitis. Patients with CD4+ counts of <100/µl and negative baseline screening eye examinations were tested for CMV infection by (i) pp65 antigenemia expression in leukocytes, (ii) the Digene Hybrid Capture CMV DNA System, and (iii) the Roche Amplicor Qualitative PCR Test. The incidence of CMV retinitis in our study of 296 patients at the Medical Center of Louisiana---New Orleans HIV Outpatient Clinic was 7.2 per 100 person-years (a total of 20 episodes in 18 patients from April 1997 to February 1999). Receiver operating characteristic curves were calculated for each assay to determine optimal cutoff points which maximized the sensitivity and specificity of each assay. The sensitivities of the assays compared to the eye examinations were 80% for the pp65 antigenemia assay (cutoff, >0 cell per 1.5 × 105 leukocytes), 85% for the Digene assay (cutoff, 1,400 genome copies/ml of whole blood), and 60% for the Amplicor assay. The specificities of the assays were 84, 84, and 87%, respectively. The Digene assay with a cutoff of >= 1,400 genome copies/ml gave optimal sensitivity and specificity and was found to have predictive values equal to those of the more technically cumbersome antigenemia assay.

* Corresponding author. Mailing address: Section of Infectious Diseases, Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave., Box SL-87, New Orleans, LA 70112. Phone: (504) 587-7316. Fax: (504) 584-3644. E-mail: mabeilke{at}mailhost.tcs.tulane.edu.

Journal of Clinical Microbiology, February 2000, p. 727-732, Vol. 38, No. 2
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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