Clinical significance of viral load in the diagnosis of cytomegalovirus disease after liver transplantation
Mendez, J.; Espy, M.; Smith, T.F.; Wilson, J.; Wiesner, R.; Paya, C.V.
Transplantation 65(11): 1477-1481
1998
ISSN/ISBN: 0041-1337 PMID: 9645806 Document Number: 486678
In a cohort of 43 liver transplant recipients who did not receive antiviral prophylaxis, qualitative and quantitative polymerase chain reactions (PCRs) from peripheral blood were prospectively compared to determine their value in the diagnosis of established cytomegalovirus (CMV) disease and for the early detection of CMV replication as a marker for preemptive antiviral therapy. Using a cutoff of 7000 copies of CMV DNA per sample, the specificity and positive predictive values of qualitative PCR for the diagnosis of established CMV disease increased from 33% to 89% and from 54% to 82%, respectively, without reducing the 100% sensitivity and negative predictive value. By contrast, quantification of viral load provided no additional advantage to qualitative PCR for the early diagnosis of CMV injection before development of disease.