Halwachs-Baumann Gabriele
Krankenhaus Steyr, Steyr, Austria.
Expert Rev Anti Infect Ther. 2007 Jun;5(3):427-39. doi: 10.1586/14787210.5.3.427.
Since the early 1990s, great efforts have been made in the field of human cytomegalovirus (HCMV) diagnosis. Besides HCMV diagnosis in immunosuppressed patients (solid organ transplant recipients, hematopoietic stem cell transplant patients and AIDS patients), diagnosis in connection with congenital HCMV infection is of great interest. This review focuses on the development and clinical utility of serological assays, as well as on virological tests (molecular and nonmolecular assays). Interpretation of these tests is strongly dependent on the patient group (solid organ transplant recipients and hematopoietic stem cell transplant patients) and whether the tests are used for screening, risk stratification or diagnosis. Furthermore, a better understanding of HCMV infection has led to new approaches in HCMV diagnosis and monitoring. Thus, assays for viral resistance testing and assays for monitoring the HCMV-specific cellular immune response are increasingly important for the guidance of antiviral therapy.
自20世纪90年代初以来,人类巨细胞病毒(HCMV)诊断领域已付出巨大努力。除了对免疫抑制患者(实体器官移植受者、造血干细胞移植患者和艾滋病患者)进行HCMV诊断外,与先天性HCMV感染相关的诊断也备受关注。本综述重点关注血清学检测以及病毒学检测(分子和非分子检测)的发展和临床应用。这些检测结果的解读很大程度上取决于患者群体(实体器官移植受者和造血干细胞移植患者)以及检测是用于筛查、风险分层还是诊断。此外,对HCMV感染的更好理解催生了HCMV诊断和监测的新方法。因此,病毒耐药性检测以及监测HCMV特异性细胞免疫反应的检测对于抗病毒治疗的指导越来越重要。