Luchsinger Vivían, Vásquez Patricia, Silva Matías, Bruno M José, Siches Izkia, Villarroel Javier, Garmendia M Luisa, Larrañaga Carmen
Rev Chilena Infectol. 2015 Dec;32(6):664-71. doi: 10.4067/S0716-10182015000700008.
Cytomegalovirus (CMV) infection is frequent in HIV adults. It is unknown usefulness of quantitative methods for diagnosing the CMV disease in Chilean patients.
To determine the performance of antigenemia and real time polymerase chain reaction (rtPCR) in the diagnosis of CMV disease in Chilean HIV adults.
Detection of CMV by viral isolation (AVR), antigenemia and quantitative rtPCR in HIV adults.
The 102 adults with suspected CMV disease had lower LTCD4 count and higher HIV viral load than 77 patients without suspicion (p < 0.05). Antigenemia and PCR were positive in 47 (46.1%) and 37 (36.3%) adults with clinical suspicion and in 2 (2.6%) and 4 (5.2%) of 77 without suspicion. The sensitivity, specificity, positive and negative predictive value of antigenemia and RPCtr were 92%, 80%, 72% and 95% and 72%, 95%, 92% and 80%, respectively. The cutoff values were ≥ lcell (+) and ≥ 5.5 log10 copies/2 x 10(6) cells. CMV was isolated in 6/179 patients (3.4%), all symptomatic.
Positivity of antigenemia and rtPCR are similar for diagnosing CMV disease in Chilean HIV adults. AVR is inappropriate as a gold standard for its low performance.
巨细胞病毒（CMV）感染在成年HIV患者中很常见。在智利患者中，定量方法诊断CMV疾病的效用尚不清楚。
确定抗原血症和实时聚合酶链反应（rtPCR）在智利成年HIV患者CMV疾病诊断中的性能。
对成年HIV患者进行病毒分离（AVR）、抗原血症检测和定量rtPCR以检测CMV。
102例疑似CMV疾病的成年人的淋巴细胞绝对计数（LTCD4）低于77例无疑似症状的患者，HIV病毒载量更高（p<0.05）。在47例（46.1%）有临床疑似症状的成年人中，抗原血症和PCR呈阳性，在77例无疑似症状的成年人中，分别有2例（2.6%）和4例（5.2%）呈阳性。抗原血症和RPCtr的敏感性、特异性、阳性预测值和阴性预测值分别为92%、80%、72%和95%以及72%、95%、92%和80%。临界值分别为≥1个细胞（+）和≥5.5 log10拷贝/2×10⁶个细胞。179例患者中有6例（3.4%）分离出CMV，均有症状。
在智利成年HIV患者中，抗原血症和rtPCR诊断CMV疾病的阳性率相似。AVR因其低效能不适宜作为金标准。
