Comparison of the CMV antigenemia and CMV-DNA QPCR results in haematopoetic stem cells transplanted recipients - A retrospective observational study

Objectives: Diagnosis of active cytomegalovirus (CMV) infection in hematopoietic stem cell (HSC)-transplanted patients is essential because of the serious complications it causes, especially CMV disease. Such diagnosis allows the initiation of a preemptive antiviral therapy, which avoids the development of such disease. In this retrospective study made as a part of routine work for transplanted patients, we compared two diagnosis testing for CMV-active infection such as pp65 CMV antigenemia and a quantitative real-time polymerase chain reaction (QPCR). Our purpose was to assess the contribution of these tools to the diagnosis and monitoring of active CMV infections. Materials and Methods: Five hundred and fifty-eight and 156 samples belonging to 24 HSC transplanted patients were, respectively, tested by antigenemia and QPCR. Results: For the 156 samples analyzed by both testing, a number of positive samples by a QPCR were higher than that by antigenemia (44.8% vs. 13%), with a statistically significant difference (P < 0.0001). A statistically significant correlation between viral loads of these two testing was also found (rs = 0.765). In median, QPCR becomes positive 14 days before antigenemia (P < 0.0001) and its positivity lasts for 91 days, whereas antigenemia positivity lasts only for 56 days (P < 0.001). No statistically significant difference was found between the results of these two testing in CMV disease cases. Conclusions: QPCR is a rapid, standardized assay, which permits a precocious detection of CMV DNA. Kinetic of DNA evolution is a reliable diagnostic tool and more effective than antigenemia-based assays in monitoring CMV infection.