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Abstract
The quantification of human cytomegalovirus (HCMV DNA) by real-time PCR is currently a primary option for laboratory diagnosis of HCMV infection. However, the optimal sample material remains controversial due to the use of different PCR assays. To explore the best blood component for HCMV DNA surveillance after liver transplantation, whole blood (WB), serum (SE), and plasma (PL) specimens were collected simultaneously from targeted patients and examined for HCMV DNA using one commercially available assay. The HCMV DNA-positive rate with WB (16.67%) was higher than that with either SE or PL (8.33%, both P<0.01). Quantitative DNA levels in WB were of greater magnitude than those in SE (WB-SE mean log-transformed difference, 0.99; 95%CI=0.74-1.25; P<0.0001) and PL (WB-PL mean log-transformed difference, 1.37; 95%CI=1.07-1.66; P<0.0001). Dynamic monitoring revealed that HCMV DNA in WB was positive sooner and had higher values for a longer period of time during therapy. With earlier positive detection, higher sensitivity, and yield of greater viral loads, WB compared favorably to SE or PL and hence is recommended as the superior material for HCMV DNA surveillance after liver transplantation. In addition, infant recipients require more intensive monitoring and prophylactic care because of their higher susceptibility to primary HCMV infection.
Highlights
Human cytomegalovirus (HCMV), a b-herpesvirus, circulates widely in the human population and causes opportunistic infections
The biological features of HCMV infection may contribute to this finding
When the virus replicates at a low level, such as at the early stage of reactivation or at the end of certain therapeutic regimens, only a few viruses are released into the serum or plasma
Summary
Human cytomegalovirus (HCMV), a b-herpesvirus, circulates widely in the human population and causes opportunistic infections. EDTA whole blood (WB) has been proposed as the ideal material because of larger yields of DNA loads [8,9,10]; and plasma (PL) or serum (SE) were preferred for their easier sample processing and acceptable analytical performance (1114). This lack of consensus may be mainly attributed to a variety of PCR assays using different instruments, reagents, DNA extraction methods, and conducted in different centers, leading to interlaboratory variation and creating increasing clinical concern [15,16,17,18]
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