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Journal of Clinical Microbiology, March 2000, p. 1209-1213, Vol. 38, No. 3
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Comparison of Two Commercial Methods for Measurement of Cytomegalovirus Load in Blood Samples after Renal Transplantation

C. Y. William Tong,1,* Luis E. Cuevas,2 Helen Williams,1 and Ali Bakran3

Department of Medical Microbiology, University of Liverpool,1 Statistics and Epidemiology Unit, Liverpool School of Tropical Medicine,2 and Renal Transplant Unit, Royal Liverpool University Hospital,3 Liverpool, United Kingdom

Received 25 August 1999/Returned for modification 26 October 1999/Accepted 24 December 1999

A cohort of 77 renal transplant recipients was prospectively studied for comparison of two commercially available cytomegalovirus (CMV) load assays, i.e., the COBAS AMPLICOR CMV Monitor test (Amplicor), using plasma samples, and the Murex Hybrid Capture System (HCS), using whole blood. The manufacturer of the HCS assay changed the version of the test from 1.0 (HCS-1) to 2.0 (HCS-2) after the first 37 patients had been tested. Despite the differences in principle and type of specimen used, the Amplicor and HCS assays gave comparable results. The regression line correlating the HCS-1 assay to the Amplicor assay was similar to that correlating the HCS-2 assay to the Amplicor assay. The HCS results could be converted to Amplicor-equivalent units by using linear-regression equations [log10 HCS-1 result = 0.49 (log10 Amplicor result) + 2.58, and log10 HCS-2 result = 0.61 (log10 Amplicor result) + 2.18]. The HCS-2 assay appeared to have the lowest detection limit, followed by the Amplicor assay and then the HCS-1 assay. When a sliding scale of cutoff values in Amplicor-equivalent units (>1,000, >2,500, >6,000, >16,000, >40,000, and >100,000 copies/ml) was applied to diagnose CMV disease, similar patterns of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were observed with the Amplicor and HCS assays. A cutoff value of >40,000 copies/ml has a low sensitivity (Amplicor, 29.4%; HCS, 41.2%) but is specific (Amplicor, 96.7%; HCS, 93.3%) and can be used for the differential diagnosis of CMV disease (PPV, 71.4% [Amplicor] or 63.6% [HCS]; NPV, 82.9% [Amplicor] or 84.8% [HCS]). A lower cutoff value of >1,000 copies/ml improves the sensitivity (Amplicor, 76.5%; HCS, 82.4%) and has a high NPV (Amplicor, 91.8%; HCS, 94.2%) but, due to the low PPV (Amplicor, 46.2%; HCS, 56%), is useful only for exclusion of CMV disease.

* Corresponding author. Mailing address: Department of Medical Microbiology, University of Liverpool, 8th Floor, Duncan Building, Royal Liverpool University Hospital, Liverpool L69 3GA, United Kingdom. Phone: 44-151-706-4398. Fax: 44-151-706-5805. E-mail: cywtong{at}liv.ac.uk.

Journal of Clinical Microbiology, March 2000, p. 1209-1213, Vol. 38, No. 3
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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