거대세포바이러스 감염증의 조기진단을 위한 PCR및 early antigen 면역염색법의 유용

Abstract

Background :Cytomegalovirus infection is an important cause of morbidity and mortality alter organ transplantation. Thus, rapid, sensitive and specific laboratory test, such as CMV anti-genemia assay and polymerase chain reaction (PCR) is necessary to determine a patient`s risk of CMV disease and to monitor the effectiveness of antiviral therapy. We compared the results of CMV-PCR and CMV early antigen immunostaining (CMV-EA) with CMV-specific IgM antibody to evalutate clinical usefulness for the early diagnosis of CMV infection anti monitoring of antiviral therapy Method :We analyzed 170 samples submitted for CMV tests between September 1995 and April 1996 in Yonsei University College of Medicine Severance Hospital. CMV-PCR and CMV-EA were performed with buffy coat cells and detection of CMV-specific IgM antibody was performed by enzyme-linked fluorescent assay (ELFA) Result :One hundred and seventy samples of 159 patients were tested anti analyzed The concordance rate of CMV-PCR, CMV-EA anti CMV-specific IgM In the same blood sample was 753%. The total Incidence of CMV disease was 25%. The sensitivity anti specificity based on the patients clinical status of PCR were 100% and 91.6% respectively in CMV-EA immunostaining method, they were 750% and 100% respectively, And, for CMV-specific IgM antibody ELFA, the sensitivity was only 500% anti the specificity was 96.4%. Conclusion :CMV-PCR and CMV-EA immunostaining are reliable methods as rapid early detection of CMV infection. The sensitivity and specificity are very high comparing to CMV-specific IgM antibody. It could also be concluded that they haute advantages not only for early diagnosis but also monitoring or follow-up of a therapeutic course as quantitative assays.