Presence Of Cytomegalovirus Antibodies Research Articles

Seroprevalence of cytomegalovirus infection in antenatal women in a Tertiary Care Center in Western India

Context: Human cytomegalovirus (CMV), otherwise called human herpesvirus 5, is a member of the Herpesviridae family. Maternofetal transmission of CMV can occur during pregnancy following primary or recurrent infections in the mother. Infections in utero are associated with fetal abnormalities, intrauterine growth retardation, and intrauterine death. In India, 80%–90% of the adult population show presence of CMV antibodies; however, there are few articles showing the prevalence of CMV infection in pregnant women. Aims: The aim of this study is to assess seroprevalence of CMV infection in antenatal women. Settings and Design: This is a cross-sectional, observational study, study population: women reporting for antenatal care to the OPD at a tertiary care hospital. Subjects and Methods: Three hundred and seventy serum samples drawn from antenatal women attending OPD in a tertiary care center were tested for IgG and IgM antibodies by enzyme-linked immunosorbent assay. Statistical Analysis Used: Statistical significance was estimated by calculating “P value.” Results: Of the 370 samples tested, 83% showed the presence of CMV IgG and 9.46% were positive for CMV IgM. All those cases which were IgM positive were seropositive for CMV IgG as well. Sixteen percent of the antenatal women were both IgG and IgM negative. Conclusion: The prevalence of CMV IgG in antenatal women in this region is high. Around 16% of the women showed lack of IgG. It would be beneficial to screen pregnant women for CMV IgM antibodies is beneficial and will help guide the testing of newborns suspected to be infected with CMV in order that appropriate therapy of the infected infants can be instituted promptly and appropriate advice can be rendered on prevention of transmission.

Guidelines for Donor Lung Selection: Time for Revision?

Few data support current guidelines for donor selection in lung transplantation. We determined degree of compliance with current donor guidelines, effect of these and variances on survival, and other donor factors predicting survival. From July 1999 to June 2008, 10,333 primary transplants were performed in the US, with United Network for Organ Sharing data available for age, ABO type, chest radiograph, arterial difference in partial pressure of oxygen (PaO(2)) greater than 300 on 100% fraction of inspired oxygen, smoking, absence of aspiration/sepsis, and purulent secretions. Multivariable survival methods were used to determine relevance of these and new variables, adjusted for recipient risk factors. In 56% of transplants, variance from at least one guideline was observed: chest radiograph, 41%; smoking, 21%; and PaO(2), 18%; but rarely ABO compatibility (0.06%). Practice within guidelines was not associated with increased mortality. Common variances from guidelines; eg, PaO(2)/fraction of inspired oxygen down to 230, were not associated with increased mortality, but smoking (p = 0.02) was. New donor variables associated with increased mortality were diabetes (p = 0.001), presence of cytomegalovirus antibodies (p < 0.0001), recent smoking history (p = 0.02), African-American (p = 0.005), blood type A (p = 0.02), death other than from head trauma (p = 0.02), and gender (p = 0.02), race (p = 0.03), and size (p = 0.002) discordances. Variance from current donor guidelines for lung transplantation is frequent; analysis suggests that donor PaO(2) ranges can be widened and a suspicious chest radiograph, evidence of sepsis, and purulent bronchial secretions ignored. Older age and smoking history appear to have a minor impact. New and possibly important factors identified suggest the need to better understand the impact of a wider range of donor variables on recipient outcomes.

Relationship of anti-60 kDa heat shock protein and anti-cholesterol antibodies to cardiovascular events.

Several recent studies have indicated an association between key inflammatory mediators and atherosclerotic diseases. We evaluated whether high levels of antibodies against heat shock proteins and cholesterol (ACHA) predicted cardiovascular (CV) events. We used blood samples from the Heart Outcomes Prevention Evaluation (HOPE) study to conduct a nested case-control study of 386 cases with CV events and 386 age- and sex-matched HOPE study controls without events. We explored the relationship between anti-hsp antibodies, ACHA, and subsequent outcomes (incident myocardial infarction, stroke, or CV death) during a mean follow-up of 4.5 years using conditional logistic regression. High levels of anti-hsp65 antibodies (> or =90th percentile) predicted CV events (OR, 2.1; 95% CI, 1.2 to 3.9, P=0.01). Anti-hsp60 antibodies did not predict any event type, whereas incident stroke developed significantly less frequently in patients with high ACHA levels. Anti-hsp antibodies and ACHA did not correlate with inflammatory (fibrinogen, C-reactive protein, interleukin-6, intracellular adhesion molecule-1) or infectious markers (C pneumoniae or cytomegalovirus antibodies). Anti-hsp65 antibodies (> or =90th percentile) and fibrinogen (highest tertile) had a strong joint effect: patients with high concentrations of both had more CV events (OR, 5.5; 95% CI, 1.8 to 17.5, P=0.004) than patients with low levels of both. A similar joint effect (OR, 2.7; 95% CI, 1.3 to 5.7, P=0.01) was found for high levels of anti-hsp65 and presence of cytomegalovirus antibodies. Serum antibodies to hsp65 were associated with subsequent CV events in this study of high-risk patients, independent of conventional cardiovascular risk factors and other inflammatory markers.

Studies evaluating high-dose acyclovir, intravenous immune globulin, and cytomegalovirus hyperimmunoglobulin for prophylaxis against cytomegalovirus in kidney transplant recipients.

To describe the epidemiology and pathogenesis of cytomegalovirus (CMV) and critically analyze the studies evaluating the cost, safety, and efficacy of high-dose acyclovir, intravenous immune globulin (IVIG), and CMV hyperimmunoglobulin (CMVIG) for prophylaxis against CMV in kidney transplant recipients. Appropriate articles were identified by searching MEDLINE. Various combinations of the following medical subject heading terms were used: immunoglobulins, intravenous; acyclovir; CMVIG; CMV infections; kidney transplantation; IVIG; and prophylaxis. Studies evaluating or discussing the cost, safety, and efficacy of IVIG, high-dose acyclovir, and CMVIG in kidney transplant recipients were included. The data were evaluated with respect to study design, patient population, prophylactic regimen, incidence of CMV complications, investigators' definitions of terminology, and cost analysis. The studies are summarized in tables and discussed in the text. The definitions of terminology used by the investigators varied widely among studies. The studies were reviewed and discussed using the following definitions: CMV infection was the presence of CMV antibodies in a previously CMV-seronegative patient or a fourfold rise in antibody titer after transplantation; CMV syndrome was CMV infection plus unexplained fever, leukopenia, or thrombocytopenia in the absence of an identifiable cause; and CMV disease was CMV syndrome plus pneumonitis, enteritis, retinitis, hepatitis, or central nervous system involvement. All regimens appear to effectively reduce the incidence of CMV-associated complications compared with placebo. Due to the lack of trials comparing cost, efficacy, and safety, the most effective prophylactic treatment is unknown.

Detection of cytomegalovirus in blood donors by the polymerase chain reaction

A polymerase chain reaction (PCR) assay was developed and optimized to detect cytomegalovirus (CMV) DNA in the blood of 86 normal donors who had originally tested seropositive for CMV. Evidence of previous or current infection with CMV was determined by rescreening of the blood for CMV antibodies and by detecting the presence of infectious virus in the white cells by cell culture. DNA was extracted from the blood of donors by a manual or an automated method and amplified by PCR using primers from the major immediate early gene of CMV DNA. The amplified product was detected by visualization of a fluorescent 435-base pair DNA band in an electrophoretic agarose gel after ethidium bromide staining and confirmed by slot-blot DNA hybridization using an oligonucleotide probe with complementarity for the major immediate early gene. Seven (8%) of the 86 donors were positive for CMV DNA in both fluorescence and hybridization studies. These donors were also antibody positive. While 74 (86%) of the 86 donors were positive for the presence of CMV antibodies in enzyme-linked immunosorbent assay, none was positive for virus in cell culture. PCR has the potential to be an effective and reliable procedure for the detection of CMV DNA in donor blood, but further study is required for this technique to be used for diagnostic or routine screening purposes.

Prevalence of Cytomegalovirus Antibodies in Blood Donors

Cytomegalovirus (CMV) obtained through blood products has proven to be a significant pathogen in newborn infants and immunocompromised hosts. Serum samples from 250 blood donors were evaluated by five commercial tests for the presence of CMV antibodies. Fifty percent of the 250 donors were positive by three or more of the tests and therefore were considered to be true positives. Solid-phase fluorescence immunoassay (SFI), indirect hemagglutination assay (IHA), immunofluorescent antibody (IFA), passive latex agglutination (LA), and enzyme immunoassay (ElA) were evaluated for sensitivity, specificity, and ease of use. SFI, ELISA, and LA tests had high sensitivity and specificity ratings. IHA and IF A had high sensitivity ratings but poor specificity rates. IHA and LA had the best functional ratings, followed in order by SFI, ELISA, and I FA. Our findings suggest that LA is the best choice among these tests for an accurate, reliable, and simple screening test for CMV antibodies.

Prevalence of cytomegalovirus antibody in hemophiliacs and homosexuals infected with human immunodeficiency virus type 1.

We determined the prevalence of antibody to cytomegalovirus (CMV) in the sera of non-homosexual hemophilia patients and homosexual men infected with the human immunodeficiency virus type 1 (HIV-1). CMV antibody testing by latex agglutination revealed 33 of 58 HIV-1 infected hemophiliacs (57%) were antibody-positive compared with 54 of 54 HIV-1 infected asymptomatic non-hemophiliac homosexuals (100%) (p less than .001). Nine of 15 hemophiliacs (60%) with symptomatic HIV-1 infection were CMV antibody-positive. We also tested 22 HIV-1 antibody-negative hemophiliacs who had received non-heat treated factor concentrates. 14 of these 22 (64%) were CMV antibody-positive compared with 57% of HIV-1 antibody-positive hemophiliacs. We conclude 1) there is little correlation between transmission of HIV-1 and CMV by factor concentrates, 2) the presence of CMV antibody does not appear to be associated with clinical stage of HIV-1 infection in hemophiliacs, and 3) there may be a significant number of CMV antibody-negative hemophiliacs with HIV-1 infection at risk for primary infection and subsequent disease if CMV seronegative blood products are not provided for future transfusions.