Yoshida Atsushi
Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA.
Rinsho Byori. 2008 Nov;56(11):1034-42.
In the diagnosis of human cytomegalovirus diseases, marked developments and improvements are achieved through laboratory methods. Quantitative PCR-based technologies including the real-time PCR assay are used for the quantitation of CMV DNA and mRNA in blood, bronchoalveolar lavage, cerebrospinal fluid, and amniotic fluid with rapidity and high-level sensitivity. In immunocompromised hosts, these assays can detect CMV DNA from blood even prior to the onset of clinical symptoms, identifying individuals at risk of developing CMV diseases. These assays are also useful in monitoring responses to antiviral treatment and predicting clinical relapse. For preemptive therapy, the thresholds can be determined for the identifying risk of diseases in each group of patients with HIV/AIDS, hematopoietic stem transplantation, and solid organ transplantation, based on PCR assays as well as pp65-antigenemia. The standardization of PCR-based techniques and evaluation of preemptive therapy through multicenter trials will be needed.
在人类巨细胞病毒疾病的诊断中，实验室方法取得了显著进展和改进。基于定量PCR的技术，包括实时PCR检测，用于快速、高灵敏度地定量检测血液、支气管肺泡灌洗液、脑脊液和羊水中的巨细胞病毒DNA和mRNA。在免疫功能低下的宿主中，这些检测甚至可以在临床症状出现之前从血液中检测到巨细胞病毒DNA，从而识别出有发生巨细胞病毒疾病风险的个体。这些检测对于监测抗病毒治疗反应和预测临床复发也很有用。对于抢先治疗，可以根据PCR检测以及pp65抗原血症，为每组艾滋病病毒/艾滋病、造血干细胞移植和实体器官移植患者确定识别疾病风险的阈值。需要基于PCR的技术标准化以及通过多中心试验评估抢先治疗。
