Costa Cristina, Sidoti Francesca, Mantovani Samantha, Gregori Gabriella, Proietti Alex, Ghisetti Valeria, Cavallo Rossana
Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Italy.
Department of Public Health and Pediatrics, University of.
New Microbiol. 2016 Jul;39(3):186-191. Epub 2016 Jun 10.
In immunosuppressed patients, pre-emptive therapy and a strict follow-up of CMV infection are the standard of care for the prevention of CMV disease. Several real-time PCR assays for CMV DNA quantification on whole blood (WB) and plasma (PL) are commercially available. This study compared and correlated CMV viral loads obtained by the Cobas AmpliPrep/Cobas TaqMan (CAP/CTM) platform on plasma specimens with those obtained on corresponding whole blood specimens by the real-time PCR assay (ELITe MGB-CMV) in 185 sequential samples from 41 immunosuppressed patients. Correlation between the two assays was good. Kinetics of CMV DNA within the same patient was similar, but PL viral load was constantly 1 log lower than WB. In patients under antiviral therapy, low level of CMV DNA persisted in WB, while it was absent in PL. The good correlation between CMV DNA detected on both PL and WB supports the reliability of the two matrices for viral monitoring and the therapeutic management of CMV infection. Nevertheless, due to significant quantification differences between PL and WB CMV DNA, the same biological specimen should be used for a sequential and reliable follow-up of patients at high risk of CMV infection.
在免疫抑制患者中，抢先治疗和对巨细胞病毒（CMV）感染进行严格随访是预防CMV疾病的标准治疗方法。有几种用于全血（WB）和血浆（PL）中CMV DNA定量的实时聚合酶链反应（PCR）检测方法可供商业使用。本研究比较了41例免疫抑制患者的185份连续样本中，通过Cobas AmpliPrep/Cobas TaqMan（CAP/CTM）平台在血浆样本上获得的CMV病毒载量与通过实时PCR检测（ELITe MGB-CMV）在相应全血样本上获得的CMV病毒载量，并进行了相关性分析。两种检测方法之间的相关性良好。同一患者体内CMV DNA的动力学相似，但血浆病毒载量始终比全血低1个对数级。在接受抗病毒治疗的患者中，全血中持续存在低水平的CMV DNA，而血浆中则没有。血浆和全血中检测到的CMV DNA之间的良好相关性支持了这两种样本用于病毒监测和CMV感染治疗管理的可靠性。然而，由于血浆和全血中CMV DNA的定量存在显著差异，对于CMV感染高危患者的连续和可靠随访，应使用相同的生物样本。
