Roberts T C, Brennan D C, Buller R S, Gaudreault-Keener M, Schnitzler M A, Sternhell K E, Garlock K A, Singer G G, Storch G A
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
J Infect Dis. 1998 Sep;178(3):626-35. doi: 10.1086/515383.
Cytomegalovirus (CMV) DNA levels were measured by quantitative-competitive polymerase chain reaction (PCR) in weekly leukocyte samples from 50 renal transplant recipients, including 23 with symptomatic and 27 with asymptomatic CMV infection. Peak and week 4 CMV DNA levels were higher in symptomatic subjects (P = .07 and .02, respectively). In a logistic regression model, the logarithm of the week 4 level independently predicted symptomatic infection (odds ratio, 1.78 for a 1 log10 increase; 95% confidence interval, 1.14-2.78; P = .01). All subjects whose week 4 level exceeded 1000 copies/100,000 leukocytes developed symptoms. In subjects with adequate samples for analysis, CMV levels declined exponentially with ganciclovir treatment, with an average half-life of 3.3 days. Levels exceeding 10,000 copies were associated with prolonged time to clearing of CMV DNA. Potential clinical applications of quantitative CMV PCR include predicting occurrence of symptomatic first episodes after transplantation and individualizing duration of antiviral therapy.
通过定量竞争聚合酶链反应（PCR）对50名肾移植受者的每周白细胞样本进行巨细胞病毒（CMV）DNA水平检测，其中包括23名有症状的CMV感染患者和27名无症状的CMV感染患者。有症状患者的CMV DNA峰值水平和第4周水平更高（分别为P = 0.07和0.02）。在逻辑回归模型中，第4周水平的对数可独立预测有症状感染（每增加1 log10，比值比为1.78；95%置信区间为1.14 - 2.78；P = 0.01）。所有第4周水平超过1000拷贝/100,000白细胞的患者均出现症状。在有足够样本进行分析的患者中，接受更昔洛韦治疗后CMV水平呈指数下降，平均半衰期为3.3天。水平超过10,000拷贝与CMV DNA清除时间延长相关。定量CMV PCR的潜在临床应用包括预测移植后有症状首次发作的发生以及个体化抗病毒治疗的持续时间。
