Baldanti F, Revello M G, Percivalle E, Gerna G
Servizio di Virologia, IRCCS Policlinico S. Matteo, Pavia, Italy.
J Clin Virol. 1998 Jul 24;11(1):51-60. doi: 10.1016/s0928-0197(98)00040-3.
Quantification of viral load in blood has proven to be helpful in the follow-up of disseminated HCMV infections in immunocompromised patients.
(i) To describe the antigenemia assay and its optimization and (ii) to analyze the use of the antigenemia assay for the diagnosis and monitoring of HCMV infections and for the detection of treatment failures.
This article is intended to give an overview of our experience in the use of the antigenemia assay.
In solid organ transplant recipients and patients with AIDS, HCMV symptomatic infections mostly appear when antigenemia values are > 300 pp65-positive PBL/2 x 10(5) examined. To avoid the appearance of overt HCMV disease antiviral treatment could be administered when antigenemia levels are > 100 pp65-positive PBL/2 x 10(5) examined. Bone marrow transplant recipients show symptomatic HCMV infections when antigenemia values are > 100 pp65-positive PBL/2 x 10(5) examined. This group of patients should be treated when antigenemia levels are < 10 pp65-positive PBL/2 x 10(5) examined due to the higher mortality rate associated with HCMV complications. A decrease in antigenemia levels during therapy indicates a good response to antiviral drug, while stable or increasing values document a treatment failure and the emergence of drug-resistant HCMV strains.
血液中病毒载量的定量已被证明有助于免疫功能低下患者播散性人巨细胞病毒（HCMV）感染的随访。
（i）描述抗原血症检测及其优化方法，（ii）分析抗原血症检测在HCMV感染诊断、监测及治疗失败检测中的应用。
本文旨在概述我们使用抗原血症检测的经验。
在实体器官移植受者和艾滋病患者中，当抗原血症值>300 pp65阳性外周血淋巴细胞（PBL）/2×10⁵个被检测细胞时，HCMV症状性感染大多出现。为避免明显的HCMV疾病出现，当抗原血症水平>100 pp65阳性PBL/2×10⁵个被检测细胞时，可给予抗病毒治疗。骨髓移植受者当抗原血症值>100 pp65阳性PBL/2×10⁵个被检测细胞时出现症状性HCMV感染。由于与HCMV并发症相关的死亡率较高，该组患者当抗原血症水平<10 pp65阳性PBL/2×10⁵个被检测细胞时应接受治疗。治疗期间抗原血症水平下降表明对抗病毒药物反应良好，而稳定或升高的值则表明治疗失败及耐药HCMV毒株的出现。
