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Title: Molecular Tests For Cytomegalovirus Do Not Always Agree

URL: http://www.blackwell-synergy.com/Journals/processfree2.asp?conte
ntid=clm.2001.1&filetype=abstracts&article=111177&year=&journal=

"Molecular-based strategies for assessment of CMV infection and disease in immunosuppressed transplant recipients"
06/21/2001 10:13:19 AM
By Mark Pownall

Different types of molecular assays for cytomegalovirus (CMV) infection do not always agree, and clinicians should be careful when making comparisons between results using different tests, researchers have warned. Researchers from the department of virology at the Cardiff Public Health Laboratory in Wales, compared several different molecular tests for CMV and found generally good correlation for most, but not all tests. Whole blood high level polymerase chain reaction (PCR), nucleic acid sequence based amplification (NASBA) for [pp67, RNA and a commercial pp65 antigenemia test correlated well. Plasma PCR tests did not however equate well with whole blood tests, and inhibitors in these samples could be problematic. The researchers tested the methods on samples from 32 transplant recipients, immunosuppressed patients who are at risk of severe clinical manifestations of infection. Each test was used on just over 50 tissue samples from the subjects. Seven samples were positive by all methods and 36 gave a negative result with all tests. However, there were 12 samples which were positive according to some tests and negative according to others. Whole blood PCR gave more positive results but other tests suggest some of these may have been false positives because the samples showed no other evidence of viral replication. The results demonstrate a low positive predictive value for sensitive qualitative PCR assays. The researchers say that such tests can provide useful information for clinical management, but they warn against comparing results from different assays. They conclude that large comparative studies are needed to determine the test with the best balance between sensitivity, specificity and clinical relevance in different patient groups.

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