Weber B, Nestler U, Ernst W, Rabenau H, Braner J, Birkenbach A, Scheuermann E H, Schoeppe W, Doerr H W
Institut für Medizinische Virologie, Zentrum der Hygiene, Universitätskliniken Frankfurt, a. M., Germany.
J Med Virol. 1994 Jun;43(2):187-93. doi: 10.1002/jmv.1890430217.
Seventy-five organ transplant recipients underwent prolonged virological and serological follow-up for early detection of human cytomegalovirus (HCMV) infection after transplantation. HCMV DNA detection by nested polymerase chain reaction (PCR) and HCMV early structural antigen (pp65) detection were carried out in 576 peripheral blood leucocyte (PBL) samples. Furthermore, 563 blood specimens were investigated by a commercially available enzyme-linked immunosorbent assay (ELISA) for the detection of specific immunoglobulins G, M, and A against HCMV structural antigens. In eight of nine symptomatic organ transplant recipients, HCMV DNA was detected in one or more consecutive blood samples. HCMV DNA PCR was also positive in one or more samples from eight patients who never developed HCMV-related symptoms. HCMV pp65 antigen was detected almost exclusively in PBL samples from organ transplant recipients suffering from HCMV disease. However, antigenaemia was not detected in four PCR positive patients presenting clinical signs attributable to HCMV infection. Two of the initially HCMV DNA positive samples were not confirmed by retesting and hybridisation. The results of the present study demonstrate that despite the high specificity of nested PCR, HCMV DNA may be detected in the absence of clinical symptoms attributable to HCMV infection. In asymptomatic reactivation, limited replication of viral DNA may be responsible for positive results of PCR without any clinical relevance. In this context, pp65-antigen detection from PBL seems to have a better prognostic value, but is not always detected when clinical symptoms are present.
75名器官移植受者接受了长期的病毒学和血清学随访，以便在移植后早期检测人巨细胞病毒（HCMV）感染。对576份外周血白细胞（PBL）样本进行了巢式聚合酶链反应（PCR）检测HCMV DNA以及检测HCMV早期结构抗原（pp65）。此外，还通过一种市售的酶联免疫吸附测定（ELISA）对563份血液标本进行检测，以检测针对HCMV结构抗原的特异性免疫球蛋白G、M和A。在9名有症状的器官移植受者中，有8名在一份或多份连续血样中检测到HCMV DNA。在8名从未出现过HCMV相关症状的患者的一份或多份样本中，HCMV DNA PCR也呈阳性。HCMV pp65抗原几乎仅在患有HCMV疾病的器官移植受者的PBL样本中检测到。然而，在4名出现可归因于HCMV感染临床症状的PCR阳性患者中未检测到抗原血症。最初的2份HCMV DNA阳性样本经重新检测和杂交后未得到证实。本研究结果表明，尽管巢式PCR具有高特异性，但在没有可归因于HCMV感染的临床症状时也可能检测到HCMV DNA。在无症状再激活中，病毒DNA的有限复制可能导致PCR结果呈阳性，但无任何临床意义。在这种情况下，从PBL中检测pp65抗原似乎具有更好的预后价值，但在出现临床症状时并不总是能检测到。
