Human cytomegalovirus immediate early and late transcripts in peripheral blood leukocytes: diagnostic value in renal transplant recipients.

Peripheral blood leukocytes of renal transplant recipients were investigated to compare the following markers of human cytomegalovirus (HCMV) infection: pp65 antigen by indirect immunofluorescence, viral DNA by nested polymerase chain reaction (PCR), and immediate early (IE) and late (pp150) mRNA by nested PCR following reverse transcription. Sixty-five patients were monitored weekly for 20 weeks after transplantation. In 76 samples from 20 patients positive for HCMV DNA by PCR, HCMV mRNA was detected. Detectable amounts of IE and pp150 mRNA were positively correlated with high numbers of pp65 antigen-positive cells and confirmed the significance of pp65 antigen as a marker for active viral replication. However, with respect to the early diagnosis of HCMV-related disease and monitoring of antiviral therapy, the test for viral mRNA was not superior to the pp65 antigen test.