Revello M G, Baldanti F, Furione M, Sarasini A, Percivalle E, Zavattoni M, Gerna G
Institute of Infectious Diseases, University of Pavia, Italy.
J Med Virol. 1995 Dec;47(4):462-6. doi: 10.1002/jmv.1890470428.
The reliability of the polymerase chain reaction (PCR) for prenatal diagnosis of human cytomegalovirus (HCMV) infection was determined by retrospective testing of 35 amniotic fluids identified previously as positive or negative for HCMV by virus isolation. Amniocentesis was performed in 26 pregnant women with primary HCMV infection at 14-36 weeks gestation, 3-21 weeks after maternal infection. Blood samples were obtained from 20 fetuses for IgM determination and/or virus isolation. Amniotic fluid culture led to antenatal diagnosis of HCMV in 9 of the 13 infected fetuses (sensitivity 69.2%) with one case diagnosed at a second sampling. PCR was able to detect one additional infected fetus (10/13, sensitivity 76.9%). Nested PCR did not increase sensitivity of prenatal diagnosis. Three cases were not diagnosed by all the techniques employed. The specificity of virus isolation from and DNA detection by PCR in amniotic fluid was 100%. The negative predictive value for virus isolation from amniotic fluid was 76.5% and for DNA detection by PCR 81.2%, whereas the positive predictive value was 100% for both techniques. The results showed that neither approach can detect all cases of congenital HCMV infection prenatally, and that the time interval between maternal infection and sampling seems to be a major factor affecting the reliability of prenatal diagnosis.
通过对35份羊水样本进行回顾性检测来确定聚合酶链反应（PCR）用于产前诊断人巨细胞病毒（HCMV）感染的可靠性，这些羊水样本先前通过病毒分离法被鉴定为HCMV阳性或阴性。对26例妊娠14 - 36周、母体感染后3 - 21周的原发性HCMV感染孕妇进行了羊膜腔穿刺术。从20例胎儿获取血样用于IgM测定和/或病毒分离。羊水培养在13例受感染胎儿中的9例中实现了HCMV的产前诊断（敏感性69.2%），其中1例在第二次采样时被诊断。PCR能够检测出另外1例受感染胎儿（10/13，敏感性76.9%）。巢式PCR并未提高产前诊断的敏感性。所有采用的技术均未诊断出3例病例。从羊水进行病毒分离以及通过PCR进行DNA检测的特异性均为100%。从羊水进行病毒分离的阴性预测值为76.5%，通过PCR进行DNA检测的阴性预测值为81.2%，而两种技术的阳性预测值均为100%。结果表明，两种方法均不能在产前检测出所有先天性HCMV感染病例，并且母体感染与采样之间的时间间隔似乎是影响产前诊断可靠性的主要因素。
