Vnitr Lek 1998, 44(6):350-354

[Monitoring cytomegalovirus infection using the 2-step nested polymerase chain reaction in patients with allogenic bone marrow transplantation].

P Jindra, V Koza, P Cetkovský, P Hájek, M Svecová

Hematologicko-onkologické oddĕlení FN, Plzen.

Cytomegalovirus infections and their sequelae are the most serious complications in patients after allogenic bone marrow transplantations. Therefore in recent years quite rightly attention is paid to new diagnostic methods which make earlier and more sensitive detection of incipient CMV infection possible. The method of the two-stage polymerase chain reaction (PCR) was used for early detection of CMV infection and its possible further monitoring in 38 recipients of allogenic bone marrow. A positive result was recorded in 15 (39%) patients whereby in 10 (13%) repeated positivity was involved. In three in this group of patients (8%) CMV disease developed, always preceded by PCR positivity. Sensitivity, specificity, positive and negative predictive CMV PCR values were 100, 66, 20 and 100%. Concomitant comparison with serological examination (antibody titre class IgM/seroconversion) revealed the small contribution of serology (corresponding values are 67, 54, 11 and 95%) in patients after bone marrow transplantations. The presented results provide evidence of the contribution of PCR in the diagnosis of CMV in those patients where due to their high sensitivity and excellent predictive value it is possible to avoid the toxicity of unnecessary antiviral treatment.

Keywords: Adolescent; Adult; Antibodies, Viral, analysis, ; Bone Marrow Transplantation, adverse effects, ; Cytomegalovirus, genetics, ; Cytomegalovirus Infections, diagnosis, ; DNA, Viral, analysis, ; Female; Humans; Immunosuppression, adverse effects, ; Male; Middle Aged; Polymerase Chain Reaction; Predictive Value of Tests; Sensitivity and Specificity

Published: June 1, 1998  Show citation