Halling V W, Maine G T, Groettum C M, Wilson J A, Spesard J, Brojanac S, Combs B, Wachta D, Holas C, Wilson T, Wang D, Tomazic-Allen S, Lazzarotto T, Landini M P, Jevremovic-Simovic S, Wiesner R H, Paya C V, Smith T F
Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Transplantation. 2001 Feb 15;71(3):395-7. doi: 10.1097/00007890-200102150-00009.
Human cytomegalovirus (CMV) is a significant cause of morbidity and mortality among transplant recipients. Monitoring transplant recipients by CMV IgM serology has been questioned by several studies due to the reported insensitivity of serologic tests relative to antigen detection methods.
In this retrospective study, we have evaluated the performance of the new recombinant antigen-based Abbott AxSYM CMV IgM assay and compared it with CMV culture technique in a cohort of 40 liver transplant recipients who did not receive antiviral prophylaxis.
The sensitivity, specificity, and positive and negative predictive values for detection of CMV disease by the AxSYM CMV IgM assay were 90.0%, 60.0%, 69.2%, and 85.7%, respectively, and by culture the values were 100%, 55.0%, 69.0%, and 100%, respectively. Detection of CMV IgM occurred before or at the time of CMV disease in only R+ recipients.
Although this assay is a sensitive test for CMV-specific IgM, detection of CMV IgM preceded detection of virus by culture in patients only when the liver transplant recipient was CMV immune before transplantation (R+).
人巨细胞病毒（CMV）是移植受者发病和死亡的重要原因。由于血清学检测相对于抗原检测方法的不敏感性，几项研究对通过CMV IgM血清学监测移植受者提出了质疑。
在这项回顾性研究中，我们评估了新型基于重组抗原的雅培AxSYM CMV IgM检测方法的性能，并将其与40名未接受抗病毒预防的肝移植受者队列中的CMV培养技术进行了比较。
AxSYM CMV IgM检测方法检测CMV疾病的敏感性、特异性、阳性预测值和阴性预测值分别为90.0%、60.0%、69.2%和85.7%，而培养法的值分别为100%、55.0%、69.0%和100%。仅在R+受者中，CMV IgM的检测在CMV疾病之前或之时出现。
尽管该检测方法对CMV特异性IgM是一种敏感的检测方法，但仅当肝移植受者在移植前对CMV免疫（R+）时，患者中CMV IgM的检测才先于病毒培养检测。
