Human cytomegalovirus infection

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Abstract
In recent years there have been major advances in the field of rapid diagnosis of human cytomegalovirus (HCMV) infections. p72-Specific monoclonal antibodies (mAbs) have led to early identification of HCMV isolates from different clinical samples, particularly peripheral blood leukocytes (PBL). Determination and quantification of viraemia has proven to be particularly useful in the identification of immunocompromized patients with, or at risk for, HCMV disease. The antigenaemia assay represents a major breakthrough, based upon detection of the HCMV lower matrix phosphoprotein (pp65) in nuclei of PBL. Quantitative antigenaemia has been found to be an extremely useful test for diagnosing symptomatic HCMV infection as well as for monitoring the effects of specific antiviral treatment. Recently, HCMV-infected endothelial giant cells have been reported to circulate during disseminated HCMV infections in patients with overt HCMV organ syndromes. In addition, pp65-positive polymorphonuclear leukocytes have been detected in the cerebrospinal fluid of AIDS patients with polyradiculoneuropathy and encephalitis, providing an additional tool for rapid diagnosis of HCMV infections of the nervous system. Finally, DNA amplification by the polymerase chain reaction (PCR) has been extensively used for the detection of HCMV DNA and RNA in clinical samples, and particularly in blood. However, qualitative PCR does not provide clinically useful information, except when DNA is detected in aqueous humor or in cerebrospinal fluid. Quantitative PCR is of greater diagnostic relevance.

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