COMPARISON BETWEEN ANTIGENEMIA AND A QUANTITATIVE-COMPETITIVE POLYMERASE CHAIN REACTION FOR THE DIAGNOSIS OF CYTOMEGALOVIRUS INFECTION AFTER HEART TRANSPLANTATION1

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Abstract
Background Antigenemia and quantitative polymerase chain reaction (PCR) are widely used for cytomegalovirus (CMV) diagnosis after heart transplantation due to their enhanced, predictive values for disease detection when specific cut-off Values are used. the purpose of this study was to compare, in the same patient setting, the predictive values of quantitative PCR and antigenemia for GMV disease detection, using specific cut-off values.Methods. Thirty heart transplant receptors were prospectively monitored for active CMV infection and disease detection, using quantitative PCR and anti-genemia, Positive and negative predictive values for CMV disease detection were calculated using cut-off values for both antigenemia (5 and 10 positive cells/ 300,000 neutrophils) and quantitative-PCR (50,000 and 100,000 copies/10(6) leukocytes).Results, Active CMV infection was diagnosed in 93.3% of patients and CMV disease in 23.3%, the positive and negative predictive (%) values for CMV disease detection were 35/100 and 46.7/100, respectively, for quantitative PCR and antigenemia. Using 5 and 10 positive cells/300,000 neutrophils as cut-off values for antigenemia, the positive and negative predictive values (%) for disease detection were respectively 63.6/100 and 70/100, for quantitative PCR, the positive and negative predictive values (%) for cut-off values of 50,000 and 100,000 copies/10(6) leukocytes were 53.8/100 and 60/94.1, respectively.Conclusion. in our series, antigenemia and quantitative-PCR had enhanced and similar predictive values for CMV disease detection when specific cut-off values were used. the choice between these two methods for disease detection may rely less on their efficiency and more on the experience and familiarity with them.Univ São Paulo, Sch Med, Inst Heart, São Paulo, BrazilUniv São Paulo, Sch Med, Virol Lab, Inst Met Trop São Paulo,Infect Dis Dept, São Paulo, BrazilLudwig Inst Canc Res, São Paulo, BrazilWeb of Scienc

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