Moses S, Malathi J, Singha N R, Bagyalakshmi R, Madhavan H N
L and T Microbiology Research Center, Kamal Nayan Bajaj Research Centre, Vision Research Foundation, Sankara Nethralaya 41, College Road, Chennai, India.
Indian J Nephrol. 2012 Sep;22(5):347-52. doi: 10.4103/0971-4065.103909.
Human cytomegalovirus (HCMV) is an important cause of morbidity and mortality in immunosuppressed transplant recipients. Isolation of HCMV from peripheral blood leukocytes (PBLs) is considered a reliable marker of disseminated HCMV infection. HCMV pp65 antigenemia is widely used for monitoring CMV infection and guiding preemptive therapy. The aim of this study was to compare pp65 antigenemia with culture technique for detection of HCMV in PBLs among kidney transplant patients and also to determine the threshold value of significant pp65 antigenemiat. Fifty-one peripheral blood samples from post-renal transplant patients collected during August 2009 to March 2011 were processed for pp65 antigenemia assay. These were also tested for isolation of the virus by inoculation into human corneal fibroblast cells. The results of pp65 antigenemia and culture were compared to determine the clinical significance of pp65 antigenemia. HCMV was isolated in 21 cases. On comparing the pp65 antigenemia results with that of the viral isolation, a mean of 23 cells was determined to yield a positive isolation of HCMV. The values of pp65 antigenemia and isolation results were correlated (paired t-test, P = 0.0029). A pp65 count of 23 and above was considered significant in our clinical settings since we found that these clinical specimens yield positive culture result.
人巨细胞病毒(HCMV)是免疫抑制的移植受者发病和死亡的重要原因。从外周血白细胞(PBL)中分离出HCMV被认为是播散性HCMV感染的可靠标志物。HCMV pp65抗原血症被广泛用于监测CMV感染和指导抢先治疗。本研究的目的是比较pp65抗原血症与培养技术在肾移植患者PBL中检测HCMV的情况,并确定显著pp65抗原血症的阈值。对2009年8月至2011年3月期间收集的51份肾移植术后患者的外周血样本进行pp65抗原血症检测。还通过接种到人角膜成纤维细胞中检测病毒的分离情况。比较pp65抗原血症和培养结果以确定pp65抗原血症的临床意义。21例中分离出HCMV。将pp65抗原血症结果与病毒分离结果进行比较,确定平均23个细胞可产生HCMV阳性分离。pp65抗原血症值与分离结果相关(配对t检验,P = 0.0029)。在我们的临床环境中,pp65计数为23及以上被认为具有显著意义,因为我们发现这些临床标本产生阳性培养结果。