Reina J, Riera M, Bestard X, Villalonga C, Gascó J
Unidad de Virología, Servicio de Microbiología Clínica, Hospital Universitario Son Dureta.
Med Clin (Barc). 1998 Mar 7;110(8):281-4.
To study the principal virological aspects of 1,000 blood samples processed for cytomegalovirus (CMV) isolation (viremia) and pp65 antigenemia assay in immunosuppressed patients, and to compare the diagnostic efficacy of both technics.
All the blood samples collected with EDTA, were fraccionated by dextran sedimentation. The polymorfonuclear rich fraction was used for the isolation of CMV by the shell-vial cell culture and the pp65 antigenemia assay. The cell cultures were stained at 18-24 hours with a monoclonal antibody against p72 CMV antigen.
The 1,000 blood samples studied belonged to 363 patients (299 infected by the HIV, 49 renal transplant recipients, and 15 patients with haematologic diseases). 78 patients (21.4%) developed a CMV infection and/or disease. The overall results obtained in the comparative study for the CMV detection in peripheral blood were 86.7% for the antigenemia assay and 58.5% for the shell-vial culture (p = 0.0001). Of 49 patients with renal transplant, 20 (40.8%) presented with a CMV infection versus 19.3% in the HIV-positive group. The transplant recipient patients presented most frequently positivity for both diagnostic technics, and the HIV-positive patients a higher percentage of antigenemia-positive with culture negative. The shell-vial culture (viremia) had most diagnostic efficacy in the transplant recipients group.
In the immunosuppressed patients the pp65 antigenemia assay has demonstrated a high diagnostic efficacy for CMV detection in peripheral blood. However because the antigenemia not always correlates with a replicative viral load, it is necessary to routinely perform culture of the blood in a cell culture system, preferently by the shell-vial method, because this system allows to make the diagnosis of CMV infection in a short period of time.
研究1000份为免疫抑制患者进行巨细胞病毒（CMV）分离（病毒血症）和pp65抗原血症检测而处理的血样的主要病毒学方面，并比较两种技术的诊断效能。
所有用乙二胺四乙酸（EDTA）采集的血样，通过葡聚糖沉降进行分离。富含多形核白细胞的部分用于通过空斑小室细胞培养和pp65抗原血症检测来分离CMV。细胞培养物在18 - 24小时用抗p72 CMV抗原的单克隆抗体染色。
所研究的1000份血样属于363例患者（299例感染人类免疫缺陷病毒（HIV），49例肾移植受者，15例血液系统疾病患者）。78例患者（21.4%）发生了CMV感染和/或疾病。外周血CMV检测比较研究的总体结果是，抗原血症检测为86.7%，空斑小室培养为58.5%（p = 0.0001）。49例肾移植患者中，20例（40.8%）出现CMV感染，而HIV阳性组为19.3%。移植受者患者两种诊断技术的阳性率最高，HIV阳性患者抗原血症阳性且培养阴性的比例更高。空斑小室培养（病毒血症）在移植受者组中诊断效能最高。
在免疫抑制患者中，pp65抗原血症检测在外周血CMV检测中显示出高诊断效能。然而，由于抗原血症并不总是与复制性病毒载量相关，有必要常规在细胞培养系统中进行血样培养，优先采用空斑小室法，因为该系统能在短时间内诊断CMV感染。
