Utility of urine and leukocyte cultures and plasma DNA polymerase chain reaction for identification of AIDS patients at risk for developing human cytomegalovirus disease.

Utility of urine and leukocyte cultures and plasma DNA polymerase chain reaction for identification of AIDS patients at risk for developing human cytomegalovirus disease.
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利用尿液和白细胞培养以及血浆 DNA 聚合酶链式反应来识别有患人类巨细胞病毒疾病风险的艾滋病患者。

DOI:
10.1093/infdis/175.2.302
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发表时间:
1997
期刊:
The Journal of infectious diseases
影响因子:
--
通讯作者:
Spector,SA
Spector,SA
中科院分区:
--
文献类型:
--
作者:
Shinkai,M;Bozzette,SA;Powderly,W;Frame,P;Spector,SA

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尿液和血液白细胞培养和定性血浆聚合酶链反应(PCR)和定量竞争(QC)PCR的能力,以确定艾滋病患者的人巨细胞病毒(HCMV)疾病的风险进行了评估。每3个月对艾滋病患者进行一次尿和血标本随访。在平均12个月的随访中,26例(28%)发生HCMV疾病。尿培养的敏感性、特异性、阳性预测值和阴性预测值分别为85%、29%、31%和83%,白细胞培养的敏感性、特异性、阳性预测值和阴性预测值分别为38%、74%、69%和81%,血浆定性PCR的敏感性、特异性、阳性预测值和阴性预测值分别为89%、75%、58%和94%。对于QC-PCR(> 1000拷贝/微升),分别为35%、100%、100%和80%;对于QC-PCR(> 100拷贝/微升),分别为73%、90%、73%和90%。在41例经定性PCR鉴定血浆中有HCMV DNA的患者中,24例发生HCMV疾病的患者经QC-PCR检测HCMV DNA峰值拷贝数为1510 ± 448(平均值± SE)/μL,而17例未发生疾病的患者为161 ± 52(P= .0007)。因此,血浆PCR上级培养,用于鉴定艾滋病患者的HCMV疾病的风险,和血浆DNA的定量进一步确定高风险的人。
Urine and blood leukocyte cultures and qualitative plasma polymerase chain reaction (PCR) and quantitative competitive (QC) PCR were evaluated for their ability to identify AIDS patients at risk for human cytomegalovirus (HCMV) disease. AIDS patients were followed with urine and blood specimens every 3 months. During a mean follow-up of 12 months, 26 (28%) developed HCMV disease. The sensitivity, specificity, positive predictive value, and negative predictive value for urine culture were 85%, 29%, 31%, and 83%; for leukocyte culture were 38%, 74%, 69%, and 81%; for qualitative plasma PCR were 89%, 75%, 58%, and 94%; for QC-PCR (> 1000 copies/µL) were 35%, 100%, 100%, and 80%; and for QC-PCR (> 100 copies/µL) were 73%, 90%, 73%, and 90%, respectively. Of 41 patients identified by qualitative PCR to have HCMV DNA in plasma, the 24 who developed HCMV disease had 1510 ± 448 (mean ± SE) peak copies of HCMV DNA/µL by QC-PCR, versus 161 ± 52 for the 17 patients who did not develop disease (P= .0007). Thus, plasma PCR is superior to culture for identification of AIDS patients at risk for HCMV disease, and quantitation of plasma DNA further identifies high-risk persons.
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