在急性不适的HIV-1阳性患者中，使用定量聚合酶链反应对血液进行巨细胞病毒载量检测缺乏诊断效用。

Cytomegalovirus viral load testing of blood using quantitative polymerase chain reaction in acutely unwell HIV-1-positive patients lacks diagnostic utility.

作者信息

Edwards S G, Grover D, Scott C, Tedder R S, Pillay D, Copas A, Miller R F

机构信息

Department of Genitourinary Medicine, Mortimer Market Centre, Camden Primary Care Trust, London WC1E 6JB, UK.

出版信息

Int J STD AIDS. 2007 May;18(5):321-3. doi: 10.1258/095646207780749600.

DOI:10.1258/095646207780749600

PMID:17524192

Abstract

We examined the usefulness of measuring cytomegalovirus (CMV) viral load (VL) in blood using quantitative polymerase chain reaction (qPCR) in establishing a diagnosis of CMV end-organ disease in consecutive unwell HIV-infected patients. The indication for testing for CMV, CD4 count, CMV VL and presence of CMV end-organ disease were abstracted from case-notes. During a 42-month period, 216 tests were performed in 181 patients; the majority (61%) had CD4 counts <100 cells/microL. The prevalence of detectable CMV by qPCR was 43.5% (94/216) with a prevalence of CMV end-organ disease of 7.4% (16/216). Of patients with CMV detectable by qPCR, 72 % (50/69) had CD4 counts <100 cells/microL. For patients with definite CMV end-organ disease, the positive predictive value of detectable CMV by qPCR was 10% (9/94), and the negative predictive value was 98% (119/122). In acutely unwell HIV-infected patients, detection of CMV by qPCR is a poor predictor of CMV end-organ disease.

摘要

我们通过定量聚合酶链反应（qPCR）检测连续不适的HIV感染患者血液中的巨细胞病毒（CMV）病毒载量（VL），以评估其在诊断CMV终末器官疾病中的作用。从病例记录中提取CMV检测指征、CD4细胞计数、CMV病毒载量以及CMV终末器官疾病的存在情况。在42个月期间，对181例患者进行了216次检测；大多数（61%）患者的CD4细胞计数<100个/微升。qPCR检测到可检测CMV的患病率为43.5%（94/216），CMV终末器官疾病的患病率为7.4%（16/216）。在qPCR检测到CMV的患者中，72%（50/69）的CD4细胞计数<100个/微升。对于确诊为CMV终末器官疾病的患者，qPCR检测到可检测CMV的阳性预测值为10%（9/94），阴性预测值为98%（119/122）。在急性不适的HIV感染患者中，qPCR检测到CMV对CMV终末器官疾病的预测效果较差。