This Article Full Text Full Text (PDF) Other Versions of this Article: JCM.01499-07v1 46/2/493    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Google Scholar Articles by Garrigue, I. Articles by Thiébaut, R. PubMed PubMed Citation Articles by Garrigue, I. Articles by Thiébaut, R.

Prediction of Cytomegalovirus (CMV) Plasma Load from Evaluation of CMV Whole-Blood Load in Samples from Renal Transplant Recipients

Laboratoire de Virologie EA2968 and IFR66, Université Bordeaux 2,¹ Laboratoire de Virologie,² Clinical Epidemiology Unit,³ Unité de Transplantation Rénale, Département de Néphrologie, Centre Hospitalier Universitaire de Bordeaux,⁵ INSERM U875 Biostatistics and CIE7, F-33 076 Bordeaux, France⁴

Received 26 July 2007/ Returned for modification 14 September 2007/ Accepted 20 November 2007

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 x log₁₀ WB VL and as –0.3777 + 0.8563 x 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.

Published ahead of print on 5 December 2007.