Macartney M, Gane E J, Portmann B, Williams R
Institute of Liver Studies, King's College School of Medicine and Dentistry, London, United Kingdom.
Transplantation. 1997 Jun 27;63(12):1803-7. doi: 10.1097/00007890-199706270-00017.
We assessed a new cytomegalovirus (CMV) DNA hybridization assay. We also compared the assay with other currently used assays to determine its use in the early detection of active CMV infection.
Sequential whole blood samples collected from 109 patients who had undergone orthotopic liver transplantation were tested using the Murex hybrid capture system, cell culture, antigen detection, and serology. Liver biopsies performed during the study period for graft dysfunction in 84 patients were examined for histological features of CMV hepatitis. The biopsies were also immunostained for the presence of CMV antigens.
Fifteen patients developed clinically significant CMV disease (CMV syndrome in six patients and CMV hepatitis in nine patients, including two patients with disseminated CMV disease). In all 15, CMV DNA was detected by the hybrid capture assay between 1 and 20 days before other CMV assays. Fourteen of the 15 patients had CMV DNA levels greater than 50 pg/ml; the other patient had a value of 48 pg/ml. Of the remaining 94 patients with no evidence of CMV disease, 86 were negative by the hybrid capture assay and 8 were positive; all but one patient had values less than 50 pg/ml. DNA levels fell rapidly in all patients during antiviral therapy.
Unlike conventional CMV detection methods, this hybridization assay is an early predictor of clinically significant CMV infection after liver transplantation and also provides quantitation of viral load, allowing monitoring of antiviral therapy.
我们评估了一种新的巨细胞病毒（CMV）DNA杂交检测法。我们还将该检测法与其他目前使用的检测法进行比较，以确定其在早期检测活动性CMV感染中的应用。
对109例接受原位肝移植的患者采集的连续全血样本，使用Murex杂交捕获系统、细胞培养、抗原检测和血清学进行检测。对研究期间因移植物功能障碍而进行肝活检的84例患者，检查其CMV肝炎的组织学特征。活检组织还进行CMV抗原免疫染色。
15例患者发生了具有临床意义的CMV疾病（6例患者为CMV综合征，9例患者为CMV肝炎，包括2例播散性CMV疾病患者）。在所有15例患者中，杂交捕获检测法在其他CMV检测法之前1至20天检测到CMV DNA。15例患者中有14例的CMV DNA水平大于50 pg/ml；另1例患者的值为48 pg/ml。其余94例无CMV疾病证据的患者中，86例杂交捕获检测法结果为阴性，8例为阳性；除1例患者外，所有患者的值均小于50 pg/ml。在抗病毒治疗期间，所有患者的DNA水平均迅速下降。
与传统的CMV检测方法不同，这种杂交检测法是肝移植后具有临床意义的CMV感染的早期预测指标，还能提供病毒载量的定量分析，有助于监测抗病毒治疗。
