Priya K, Madhavan H N
Vision Research Foundation, Sankara Nethralaya, Chennai, India.
Indian J Med Res. 2002 Jan;115:5-10.
BACKGROUND & OBJECTIVES: Since fluorescent antibody test (FAT) has low sensitivity in the rapid detection of cytomegalovirus (CMV) in clinical specimens, a nested polymerase chain reaction (nPCR) to detect the CMV-DNA was evaluated.
nPCR and FAT were carried out to detect CMV in single specimens from 104 patients and dual specimens from 32 patients with suspected active CMV infection. Of the 136 patients, 3 were HIV positive.
CMV was detected by FAT alone in 3 (1.8%) and FAT and nPCR in 16 (9.5%) specimens and by nPCR alone in 84 (50.0%) specimens from 74 (54.4%) patients. nPCR increased the clinical sensitivity by 50.0 per cent in the specimens and 54.4 per cent in the patients (McNemar test, P < 0.001). Urine was found to be the ideal specimen for the detection of CMV as the detection rate in the urine was statistically higher (McNemar test, P < 0.05) than in the blood. Buffy coat and plasma samples from 35 normal blood donors were subjected to nPCR and ELISA respectively. CMV-DNA was not detected in any of the samples while anti-CMV antibodies were detected in all of them.
INTERPRETATION & CONCLUSION: The results showed that presence of CMV-DNA in the specimen indicates active infection and nPCR is a rapid, sensitive, specific and a more reliable diagnostic tool than FAT.
由于荧光抗体检测（FAT）在临床标本中快速检测巨细胞病毒（CMV）的灵敏度较低，因此对一种用于检测CMV-DNA的巢式聚合酶链反应（nPCR）进行了评估。
对104例患者的单份标本以及32例疑似活动性CMV感染患者的双份标本进行nPCR和FAT检测，以检测CMV。这136例患者中，3例为HIV阳性。
在74例（54.4%）患者的标本中，单独通过FAT检测出CMV的有3份（1.8%），通过FAT和nPCR检测出的有16份（9.5%），单独通过nPCR检测出的有84份（50.0%）。nPCR使标本的临床灵敏度提高了50.0%，患者的临床灵敏度提高了54.4%（McNemar检验，P<0.001）。发现尿液是检测CMV的理想标本，因为尿液中的检测率在统计学上高于血液中的检测率（McNemar检验，P<0.05）。分别对35名正常献血者的血沉棕黄层和血浆样本进行nPCR和ELISA检测。所有样本均未检测到CMV-DNA，但均检测到抗CMV抗体。
结果表明，标本中CMV-DNA的存在表明存在活动性感染，与FAT相比，nPCR是一种快速、灵敏、特异且更可靠的诊断工具。
