Cotte L, Drouet E, Bissuel F, Denoyel G A, Trepo C
Hepatogastroenterology and AIDS Clinical and Research Unit, Hôtel-Dieu Hospital, Lyon, France.
J Clin Microbiol. 1993 Aug;31(8):2066-9. doi: 10.1128/jcm.31.8.2066-2069.1993.
In order to assess the value of human cytomegalovirus (HCMV) DNA amplification of gastrointestinal biopsies, we studied 57 human immunodeficiency virus-infected patients with and without gastrointestinal HCMV diseases. After DNA extraction, a 406-bp fragment from the unique short region of the HCMV genome was amplified by 35 cycles of polymerase chain reaction (PCR) and semiquantified from 80 to 80,000 HCMV genomic copies. Among 12 non-AIDS patients, the PCR assay was negative for 11 of 12 duodenal and 8 of 8 colorectal samples. It was also negative for 28 of 31 duodenal and 12 of 15 colorectal samples from 31 AIDS patients without gastrointestinal HCMV diseases. Among 14 AIDS patients with gastrointestinal HCMV diseases, the PCR assay was positive for 12 of 12 patients with HCMV duodenitis and for 13 of 13 patients with HCMV colitis. Results were dichotomized between high and low HCMV-DNA copy numbers. For duodenitis, sensitivity was 92% and specificity was 100%. For colitis, sensitivity was 92% and specificity was 93%. Specificity and sensitivity were not influenced by shedding status for HCMV or by other gastrointestinal infections. HCMV DNA amplification of gastrointestinal biopsies is a sensitive and specific tool for the diagnosis of gastrointestinal HCMV diseases in AIDS patients.
为了评估胃肠道活检中人类巨细胞病毒（HCMV）DNA扩增的价值，我们研究了57例感染人类免疫缺陷病毒且有或无胃肠道HCMV疾病的患者。提取DNA后，通过35个循环的聚合酶链反应（PCR）扩增HCMV基因组独特短区域的一个406碱基对片段，并对80至80,000个HCMV基因组拷贝进行半定量。在12例非艾滋病患者中，12份十二指肠样本中的11份以及8份结肠直肠样本中的8份PCR检测呈阴性。31例无胃肠道HCMV疾病的艾滋病患者的31份十二指肠样本中的28份以及15份结肠直肠样本中的12份PCR检测也呈阴性。在14例患有胃肠道HCMV疾病的艾滋病患者中，12例HCMV十二指肠炎症患者中的12例以及13例HCMV结肠炎症患者中的13例PCR检测呈阳性。结果根据HCMV-DNA拷贝数的高低进行二分法分类。对于十二指肠炎症，敏感性为92%，特异性为100%。对于结肠炎症，敏感性为92%，特异性为93%。特异性和敏感性不受HCMV脱落状态或其他胃肠道感染的影响。胃肠道活检的HCMV DNA扩增是诊断艾滋病患者胃肠道HCMV疾病的一种敏感且特异的工具。
