Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Laboratory Medicine, Inje University Ilsan Paik Hospital, Goyang, South Korea.
Transpl Infect Dis. 2024 Aug;26(4):e14328. doi: 10.1111/tid.14328. Epub 2024 Jul 9.
Cytomegalovirus (CMV) infection is a major cause of transplantation-related morbidity and mortality. This study assessed the utility of the QuantiFERON monitor (QFM; Qiagen) for the prediction of early CMV infection and viral burden.
QuantiFERON-CMV (QF-CMV; Qiagen) and QFM were measured at the post-allogeneic hematopoietic stem cell transplantation (HSCT) week 4. CMV DNA was measured at every visit until post-HSCT week 24. The QFM cutoff specific to CMV infection was established.
At the post-HSCT week 4, the QFM cutoff predicting CMV infection was 86.95 IU/mL. While QF-CMV results at the post-HSCT week 4 were associated with high-level CMV infection (CMV DNA ≥ 5,000 IU/mL) but not with CMV infection (CMV DNA ≥ 500 IU/mL), QFM was associated with both CMV infection and high-level CMV infection. Both indeterminate QF-CMV and nonreactive QFM were associated with increased peak CMV DNA.
Low QFM is a risk factor for CMV infection and increased CMV viral loads. QFM at post-HSCT week 4 can be utilized as an assay to predict the risk and burden of early CMV infection in HSCT recipients, in conjunction with other risk factors.
巨细胞病毒 (CMV) 感染是移植相关发病率和死亡率的主要原因。本研究评估了 QuantiFERON 监测器 (QFM；Qiagen) 在预测早期 CMV 感染和病毒载量方面的效用。
在异基因造血干细胞移植 (HSCT) 后第 4 周测量 QuantiFERON-CMV (QF-CMV；Qiagen) 和 QFM。在 HSCT 后第 24 周之前，每次就诊时都测量 CMV DNA。建立针对 CMV 感染的 QFM 截止值。
在 HSCT 后第 4 周，预测 CMV 感染的 QFM 截止值为 86.95 IU/mL。虽然 HSCT 后第 4 周的 QF-CMV 结果与高水平 CMV 感染（CMV DNA ≥ 5,000 IU/mL）相关，但与 CMV 感染（CMV DNA ≥ 500 IU/mL）无关，而 QFM 与 CMV 感染和高水平 CMV 感染均相关。不确定的 QF-CMV 和非反应性 QFM 均与 CMV DNA 峰值增加相关。
低 QFM 是 CMV 感染和增加 CMV 病毒载量的危险因素。HSCT 后第 4 周的 QFM 可与其他危险因素一起用作预测 HSCT 受者早期 CMV 感染风险和负担的检测方法。
