[Antigenemia and real time polymerase chain reaction for diagnosis of cytomegalovirus disease in HIV infected adults]

Rev Chilena Infectol. 2015 Dec;32(6):664-71. doi: 10.4067/S0716-10182015000700008.
[Article in Spanish]

Abstract

Background: Cytomegalovirus (CMV) infection is frequent in HIV adults. It is unknown usefulness of quantitative methods for diagnosing the CMV disease in Chilean patients.

Aim: To determine the performance of antigenemia and real time polymerase chain reaction (rtPCR) in the diagnosis of CMV disease in Chilean HIV adults.

Method: Detection of CMV by viral isolation (AVR), antigenemia and quantitative rtPCR in HIV adults.

Results: The 102 adults with suspected CMV disease had lower LTCD4 count and higher HIV viral load than 77 patients without suspicion (p < 0.05). Antigenemia and PCR were positive in 47 (46.1%) and 37 (36.3%) adults with clinical suspicion and in 2 (2.6%) and 4 (5.2%) of 77 without suspicion. The sensitivity, specificity, positive and negative predictive value of antigenemia and RPCtr were 92%, 80%, 72% and 95% and 72%, 95%, 92% and 80%, respectively. The cutoff values were ≥ lcell (+) and ≥ 5.5 log10 copies/2 x 10(6) cells. CMV was isolated in 6/179 patients (3.4%), all symptomatic.

Conclusion: Positivity of antigenemia and rtPCR are similar for diagnosing CMV disease in Chilean HIV adults. AVR is inappropriate as a gold standard for its low performance.

Publication types

  • English Abstract
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis*
  • AIDS-Related Opportunistic Infections / immunology
  • AIDS-Related Opportunistic Infections / virology
  • Adult
  • Antigens, Viral / blood
  • Antigens, Viral / immunology*
  • Chile
  • Cytomegalovirus / immunology*
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / immunology
  • DNA, Viral / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Real-Time Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Viral Load
  • Young Adult

Substances

  • Antigens, Viral
  • DNA, Viral