Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients

Detalhes bibliográficos
Autor(a) principal: Franco,Rodrigo Fontanive
Data de Publicação: 2017
Outros Autores: Montenegro,Rosangela Munhoz, Machado,Alice Beatriz Mombach Pinheiro, Paris,Fernanda de, Menezes,Denise Silva, Manfro,Roberto Ceratti
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Nefrologia
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002017000100046
Resumo: Abstract Introduction: Cytomegalovirus (CMV) infection is a main viral infection after kidney transplantation. The diagnostic methods currently employed are pp65 antigenemia and nucleic acid amplification by polymerase chain reaction (PCR) and aim at detecting viral replication. Objective: The goal of this study was to evaluate and compare by both methods the incidence of CMV active infection in kidney transplant patients and to establishthe best clinical-laboratory correlation. Methods: Thirty sequential kidney transplant recipients were enrolled in a single center prospective cohort study. Peripheral blood samples were drawn from day 15 until the 6th month after transplantation and tested for CMV replication by pp65 antigenemia and quantitative PCR assays (qPCR). Results: Two hundred forty samples were analyzed and the incidence of active infection was similar by both methods. Time elapsed to the first positive test was almost identical but more samples tested positive by qPCR than by antigenemia in a behavior that was almost evenly distributed overtime. Agreement between tests was observed in 217 samples (90.4%; kappa = 0.529; p < 0.001) and in 25 patients the tests were concordant (83.3%; kappa = 0.667; p < 0.001). The evaluation of the diagnostic parameters for CMV replication revealed higher sensitivity for the qPCR test (82.1%) against antigenemia (59.0%). Quantitative PCR was also slightly more accurate than antigenemia. Conclusion: Our data demonstrate that both methods are suitable and have almost equivalent accuracy for the detection of post-transplant cytomegalovirus replication. The choice for either test must take in consideration the demand, execution capability and cost-effectiveness at each institution.
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spelling Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipientscytomegalovirusimmunohistochemistrykidney transplantationpolymerase chain reactionAbstract Introduction: Cytomegalovirus (CMV) infection is a main viral infection after kidney transplantation. The diagnostic methods currently employed are pp65 antigenemia and nucleic acid amplification by polymerase chain reaction (PCR) and aim at detecting viral replication. Objective: The goal of this study was to evaluate and compare by both methods the incidence of CMV active infection in kidney transplant patients and to establishthe best clinical-laboratory correlation. Methods: Thirty sequential kidney transplant recipients were enrolled in a single center prospective cohort study. Peripheral blood samples were drawn from day 15 until the 6th month after transplantation and tested for CMV replication by pp65 antigenemia and quantitative PCR assays (qPCR). Results: Two hundred forty samples were analyzed and the incidence of active infection was similar by both methods. Time elapsed to the first positive test was almost identical but more samples tested positive by qPCR than by antigenemia in a behavior that was almost evenly distributed overtime. Agreement between tests was observed in 217 samples (90.4%; kappa = 0.529; p < 0.001) and in 25 patients the tests were concordant (83.3%; kappa = 0.667; p < 0.001). The evaluation of the diagnostic parameters for CMV replication revealed higher sensitivity for the qPCR test (82.1%) against antigenemia (59.0%). Quantitative PCR was also slightly more accurate than antigenemia. Conclusion: Our data demonstrate that both methods are suitable and have almost equivalent accuracy for the detection of post-transplant cytomegalovirus replication. The choice for either test must take in consideration the demand, execution capability and cost-effectiveness at each institution.Sociedade Brasileira de Nefrologia2017-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002017000100046Brazilian Journal of Nephrology v.39 n.1 2017reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.5935/0101-2800.20170008info:eu-repo/semantics/openAccessFranco,Rodrigo FontaniveMontenegro,Rosangela MunhozMachado,Alice Beatriz Mombach PinheiroParis,Fernanda deMenezes,Denise SilvaManfro,Roberto Cerattieng2017-03-22T00:00:00Zoai:scielo:S0101-28002017000100046Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2017-03-22T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false
dc.title.none.fl_str_mv Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients
title Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients
spellingShingle Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients
Franco,Rodrigo Fontanive
cytomegalovirus
immunohistochemistry
kidney transplantation
polymerase chain reaction
title_short Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients
title_full Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients
title_fullStr Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients
title_full_unstemmed Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients
title_sort Evaluation of diagnostic tests for cytomegalovirus active infection in renal transplant recipients
author Franco,Rodrigo Fontanive
author_facet Franco,Rodrigo Fontanive
Montenegro,Rosangela Munhoz
Machado,Alice Beatriz Mombach Pinheiro
Paris,Fernanda de
Menezes,Denise Silva
Manfro,Roberto Ceratti
author_role author
author2 Montenegro,Rosangela Munhoz
Machado,Alice Beatriz Mombach Pinheiro
Paris,Fernanda de
Menezes,Denise Silva
Manfro,Roberto Ceratti
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Franco,Rodrigo Fontanive
Montenegro,Rosangela Munhoz
Machado,Alice Beatriz Mombach Pinheiro
Paris,Fernanda de
Menezes,Denise Silva
Manfro,Roberto Ceratti
dc.subject.por.fl_str_mv cytomegalovirus
immunohistochemistry
kidney transplantation
polymerase chain reaction
topic cytomegalovirus
immunohistochemistry
kidney transplantation
polymerase chain reaction
description Abstract Introduction: Cytomegalovirus (CMV) infection is a main viral infection after kidney transplantation. The diagnostic methods currently employed are pp65 antigenemia and nucleic acid amplification by polymerase chain reaction (PCR) and aim at detecting viral replication. Objective: The goal of this study was to evaluate and compare by both methods the incidence of CMV active infection in kidney transplant patients and to establishthe best clinical-laboratory correlation. Methods: Thirty sequential kidney transplant recipients were enrolled in a single center prospective cohort study. Peripheral blood samples were drawn from day 15 until the 6th month after transplantation and tested for CMV replication by pp65 antigenemia and quantitative PCR assays (qPCR). Results: Two hundred forty samples were analyzed and the incidence of active infection was similar by both methods. Time elapsed to the first positive test was almost identical but more samples tested positive by qPCR than by antigenemia in a behavior that was almost evenly distributed overtime. Agreement between tests was observed in 217 samples (90.4%; kappa = 0.529; p < 0.001) and in 25 patients the tests were concordant (83.3%; kappa = 0.667; p < 0.001). The evaluation of the diagnostic parameters for CMV replication revealed higher sensitivity for the qPCR test (82.1%) against antigenemia (59.0%). Quantitative PCR was also slightly more accurate than antigenemia. Conclusion: Our data demonstrate that both methods are suitable and have almost equivalent accuracy for the detection of post-transplant cytomegalovirus replication. The choice for either test must take in consideration the demand, execution capability and cost-effectiveness at each institution.
publishDate 2017
dc.date.none.fl_str_mv 2017-03-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002017000100046
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002017000100046
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.5935/0101-2800.20170008
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
publisher.none.fl_str_mv Sociedade Brasileira de Nefrologia
dc.source.none.fl_str_mv Brazilian Journal of Nephrology v.39 n.1 2017
reponame:Jornal Brasileiro de Nefrologia
instname:Sociedade Brasileira de Nefrologia (SBN)
instacron:SBN
instname_str Sociedade Brasileira de Nefrologia (SBN)
instacron_str SBN
institution SBN
reponame_str Jornal Brasileiro de Nefrologia
collection Jornal Brasileiro de Nefrologia
repository.name.fl_str_mv Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)
repository.mail.fl_str_mv ||jbn@sbn.org.br
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