Évaluation de la quantification du cytomégalovirus dans le sang par le test de PCR en temps réel CMV R-gene®

Abstract: Aim of the study: Diagnosing the presence of cytomegalovirus (CMV) in the blood of immunodepressed patients is often done by quantitative polymerase chain reaction (Q-PCR) even though the reference method remains the antigenemia pp65 (Ag-pp65) test. Objectives: To define the predictive value of the Q-PCR in the diagnosis of CMV disease and assess treatment efficacy using the CMV R-gene® test. To compare the Q-PCR results and feasibility with those of the Ag-pp65 test. Patients and methods: The Q-PCR was performed in 34 whole blood samples (frozen at −80°C until use) from five patients diagnosed with CMV disease, defined as the presence of clinical signs and Ag-pp65 in the nuclei of more than two cells. After extraction, viral DNA was quantified in each sample using the Q-PCR CMV R-gene® kit according to the manufacturer''s instructions. Immediately after blood was drawn, the Ag-pp65 test had been performed in 32 samples using CINAkit® (Argene). Results: The 16 samples positive by the Ag-pp65 test were also positive by PCR; six samples negative by the Ag-pp65 test were positive by PCR; and the remaining 10 samples were negative by both techniques. During treatment, the two markers’ kinetics were similar. Conclusion: The CMV R-gene® test has a predictive value as good as that of the Ag-pp65 test but is fast and easier to use. A prospective study with a greater number of patients is needed to define the prediction threshold for CMV disease. [Copyright &y& Elsevier]