Department of Pediatrics, University of Alberta, Edmonton, Canada.
Department of Transplant and Infection Immunology, Saarland University, Homburg, Germany.
J Infect Dis. 2018 Sep 8;218(8):1205-1209. doi: 10.1093/infdis/jiy309.
Passive antibodies, maternal or transfusion-acquired, make serologic determination of pretransplant cytomegalovirus (CMV) status unreliable. We evaluated 3 assays unaffected by passive antibodies, in assignment of CMV infection status in children awaiting solid organ transplant and in controls: (1) CMV nucleic acid amplification testing (NAAT), (2) quantification of CMV-specific CD4+ T cells, and (3) quantification of CD27-CD28-CD4+ T cells. Our results highlight that CMV NAAT, from urine and oropharynx, is useful in confirming positive CMV status. Detection of CMV-specific CD4+ T cells was sensitive and specific in children >18 months but was less sensitive in children <12 months. CD27-CD28-CD4+ T cells are not likely useful in CMV risk stratification in children.
被动抗体，无论是母体获得还是输血获得，都会使移植前巨细胞病毒 (CMV) 状态的血清学检测变得不可靠。我们评估了 3 种不受被动抗体影响的检测方法，用于确定等待实体器官移植的儿童和对照者的 CMV 感染状态：(1) CMV 核酸扩增检测 (NAAT)，(2) CMV 特异性 CD4+ T 细胞的定量，以及 (3) CD27-CD28-CD4+ T 细胞的定量。我们的结果强调了尿和口咽部 CMV NAAT 可用于确认 CMV 阳性状态。在 >18 个月的儿童中，CMV 特异性 CD4+ T 细胞的检测具有敏感性和特异性，但在 <12 个月的儿童中敏感性较低。CD27-CD28-CD4+ T 细胞不太可能用于儿童的 CMV 风险分层。
