Comparación de las técnicas de reacción de polimerasa en cadena en tiempo real y antigenemia para la detección de citomegalovirus en sangre de niños sometidos a trasplantes

Abstract

Background: Cytomegal virus (CMV) infections are an important cause of morbidity and mortality in transplant recipient. To date, the antigenemia assay is the most used technique for diagnostic and management of CMV :infections. However, quantification of CMV viral load by real time polymerase chain reaction (RT-PCR) has becoming the method of choice to detect CMV in a rapid, sensitive and specific manner. Objective: To compare antigenemia and RT-PCR assays in the detection of CMV in blood sample from solid organ and bone marrow transplant (BMT) in children attended at the Dr. Luis Calvo Mackenna Hospital. Methods: In a prospective study, we detect the presence of CMV in blood sample by RT-PCR and antigenemia assays. Results: We analyzed 219 blood samples from 68 children subjected to kidney, liver and BMT. Out of 219 samples analyzed, 147 were negative and 33 were positive for CMV by both techniques. Thirty-seven samples were positive only by RT-PCR and 2 by antigenemia. Considering the antigenemia as a reference, RT-PCR shows 94%, 80%, 34% and 99% sensitivity, specificity, positive and negative predictive values, respectively. The kappa coefficient between both techniques was 0.528. Conclusion: Quantitative determination of CMV viral load by RT-PCR is a sensitive technique with excellent negative predictive value compared to antigenemia. Our results support the use of RT-PCR as a technique that might facilitate the diagnostic and treatment of active CMV infection in pediatric transplants.