Time to detection of cytomegalovirus (CMV) DNA in blood leukocytes is a predictor for the development of CMV disease in CMV-seronegative recipients of allografts from CMV-seropositive donors following liver transplantation
Time to detection of cytomegalovirus (CMV) DNA in blood leukocytes is a predictor for the development of CMV disease in CMV-seronegative recipients of allografts from CMV-seropositive donors following liver transplantation
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DOI：
10.1093/infdis/173.5.1072
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发表时间：
1996-05-01
影响因子：
6.4
通讯作者：
Ehrlich, GD
中科院分区：
文献类型：
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作者：
Manez, R;Kusne, S;Ehrlich, GD
在35个巨细胞病毒（CMV）血清阴性受体的肝脏从CMV血清阳性供体，32（91%）开发CMV感染，其中24人（75%）经历了疾病。白细胞中巨细胞病毒DNA的聚合酶链反应对移植后2个月内疾病的发展具有最佳的阳性和阴性预测值，此后壳瓶或试管培养病毒血症是最好的预测因素。在发生CMV疾病的患者中，CMV DNA在移植后46天（中位数;范围，13-128）首次检测到，显著早于未发生CMV疾病的患者的77天（范围，46-174）（P = .02）。通过半定量的方法，CMV DNA水平在第一个阳性样品没有预测疾病的发展。然而，在感染过程中最大的CMV DNA水平显着更高的患者谁开发CMV疾病。在CMV血清反应阴性的受者中，移植后DNA阳性的时间可以预测疾病的进展，并可作为开始先发制人治疗的指导。
In 35 cytomegalovirus (CMV)-seronegative recipients of livers from CMV-seropositive donors, 32 (91%) developed CMV infection and 24 of them (75%) experienced disease. Polymerase chain reaction for CMV DNA in leukocytes had the best positive and negative predictive values for the development of disease within 2 months from transplantation, and shell-vial or tube culture viremia was the best predictor thereafter. In patients who developed CMV disease, CMV DNA was first detected at 46 days (median; range, 13-128) after transplantation, significantly earlier than the 77 days (range, 46-174) for those who did not develop CMV disease (P = .02). By a semiquantitative method, the CMV DNA level in the first positive sample did not predict disease development. However, the maximum CMV DNA level during infection was significantly higher in patients who developed CMV disease. In CMV-seronegative recipients of livers from CMV-seropositive donors, the time to DNA positivity following transplantation may predict disease progression and be useful as a guide for the initiation of preemptive therapy.