Aymard M, Tardy J C, Gibert R
Rev Fr Transfus Immunohematol. 1984 Jun;27(3):309-21. doi: 10.1016/s0338-4535(84)80171-3.
The Blood Transfusion Centers (B.T.C.) are mainly concerned with the selection of CMV infection free blood donors, the screening of the anti CMV antibody high titre plasma donors and the evaluation of specific anti CMV Immunoglobulin preparations. Various serological methods could be used but they are of different value depending the purposes of the B.T.C. The neutralization test (Nt), with the addition of complement is specific and detects the protecting AB against the glycoproteins of the viral envelope. The complement fixation test (CF) using extracts of CMV infected cells as antigen largely varies in its sensitivity according to the quality of the antigen. In any case, the CF test is not sensitive enough to detect a latent CMV infection in a certain percentage of the non immunosuppressed adults, but could be used for the selection of anti CMV antibody high titres carriers. Three sensitive methods: passive haemagglutination, indirect immunofluorescence and indirect ELISA tests, might be used for the detection of latent CMV infections. They detect various AB against various internal and external components of the CMV. They are submitted to various sources of errors. The sensitivity of the indirect IF test is mainly restricted by the quality of the antigen preparation, its specificity by the presence of anti cells antibodies in the sera, the Fc receptors in the antigens and the specificity of the conjugates. The indirect ELISA which is submitted to the same causes of errors is a highly sensitive test, easy to perform, reagents are available, and automatic processors have been developed. When compared with the previous techniques, the ELISA test is suitable for the screening of CMV free donors, when it is performed with an highly sensitive antigen. It could be also used for the screening of high antibody titre carriers: its correlation with the CF test is quite good (r = 0,82). When comparatively applied to the titration of Immunoglobulins preparations, made from plasmas or placentas, for either IM or IV administration, the Elisa test gives AB titres different from those obtained with Nt and indirect IF. The calibration of a standard Immunoglobulin reagent is urgently needed and double blind clinical assays of the protective effect of various preparations of specific anti CMV Immunoglobulins have to be promptly designed.
输血中心（B.T.C.）主要关注选择无巨细胞病毒（CMV）感染的献血者、筛选抗CMV抗体高滴度血浆的献血者以及评估特定的抗CMV免疫球蛋白制剂。可以使用各种血清学方法，但根据输血中心的目的，它们具有不同的价值。中和试验（Nt），加入补体后具有特异性，可检测针对病毒包膜糖蛋白的保护性抗体。以CMV感染细胞提取物为抗原的补体结合试验（CF），其敏感性根据抗原质量有很大差异。无论如何，CF试验对于检测一定比例的非免疫抑制成年人中的潜伏性CMV感染不够敏感，但可用于筛选抗CMV抗体高滴度携带者。三种敏感方法：被动血凝试验、间接免疫荧光试验和间接酶联免疫吸附测定（ELISA）试验，可用于检测潜伏性CMV感染。它们检测针对CMV各种内部和外部成分的各种抗体。它们存在各种误差来源。间接免疫荧光试验的敏感性主要受抗原制剂质量的限制，其特异性受血清中抗细胞抗体、抗原中的Fc受体以及结合物特异性的影响。受到相同误差原因影响的间接ELISA试验是一种高度敏感的试验，易于操作，有可用的试剂，并且已经开发出自动分析仪。与先前技术相比，当使用高敏感性抗原进行ELISA试验时，适用于筛选无CMV的献血者。它也可用于筛选高抗体滴度携带者：其与CF试验的相关性相当好（r = 0.82）。当比较应用于由血浆或胎盘制成的用于肌肉注射或静脉注射的免疫球蛋白制剂的滴定时，ELISA试验给出的抗体滴度与用Nt和间接免疫荧光试验获得的不同。迫切需要校准标准免疫球蛋白试剂，并且必须迅速设计各种特定抗CMV免疫球蛋白制剂保护作用的双盲临床测定。
