基于核酸序列扩增技术对肾移植和肝移植受者巨细胞病毒感染检测的诊断价值

Diagnostic value of nucleic-acid-sequence- based amplification for the detection of cytomegalovirus infection in renal and liver transplant recipients.

作者信息

Goossens V J, Blok M J, Christiaans M H, van Hooff J P, Sillekens P, Höckerstedt K, Lautenschlager I, Middeldorp J M, Bruggeman C A

机构信息

Department of Medical Microbiology, University Hospital Maastricht, Maastricht, The Netherlands.

出版信息

Intervirology. 1999;42(5-6):373-81. doi: 10.1159/000053974.

DOI:10.1159/000053974

PMID:10702720

Abstract

To evaluate the diagnostic value of nucleic-acid-sequence-based amplification (NASBA) for the detection of cytomegalovirus (CMV) infection in transplant recipients, we compared immediate early 1 (IE1) and late pp67 mRNA detection by NASBA with the antigenemia assay, PCR and viral culture in 72 renal transplant (RTx) recipients and with antigenemia and serology in 25 liver transplant (LTx) recipients. Antigenemia, viral culture and pp67 NASBA were almost equivalent for the detection of CMV in RTx recipients. In LTx recipients, antigenemia detected more positive samples and more positive recipients compared to pp67 NASBA. In RTx recipients, PCR detected more positive samples and positive recipients compared to pp67 NASBA, antigenemia and viral culture. Also the first day of detection was slightly earlier for PCR. However, IE1 NASBA was the most sensitive test and detected 96% of all positive samples and positive transplant recipients. In addition, IE1 NASBA preceded PCR and all other positive results. This makes IE1 NASBA a very attractive screening test for the early detection of CMV infection.

摘要

为评估基于核酸序列扩增技术（NASBA）检测移植受者巨细胞病毒（CMV）感染的诊断价值，我们在72例肾移植（RTx）受者中将NASBA检测即刻早期蛋白1（IE1）和晚期pp67 mRNA与抗原血症检测、聚合酶链反应（PCR）及病毒培养进行了比较，并在25例肝移植（LTx）受者中将其与抗原血症检测和血清学检测进行了比较。在RTx受者中，抗原血症检测、病毒培养及pp67 NASBA在检测CMV方面几乎等效。在LTx受者中，与pp67 NASBA相比，抗原血症检测出更多阳性样本及更多阳性受者。在RTx受者中，与pp67 NASBA、抗原血症检测及病毒培养相比，PCR检测出更多阳性样本及阳性受者。而且PCR检测出阳性结果的首日也略早。然而，IE1 NASBA是最敏感的检测方法，能检测出所有阳性样本及阳性移植受者中的96%。此外，IE1 NASBA比PCR及所有其他阳性结果出现得更早。这使得IE1 NASBA成为一种极具吸引力的用于CMV感染早期检测的筛查方法。