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

* 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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