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Abstract
Introduction: Cytomegalovirus (CMV) remains a major cause of morbidity and mortality among solid organ transplant recipients, despite remarkable advances in its diagnosis, prevention and treatment [Citation1]. The two methods that are currently used to monitor CMV infection and disease in these patients are the pp65 antigenemia assay and the quantitative nucleic acid test (QNAT) [Citation2]. The purpose of this study is to compare two different types of QNAT (the Roche COBAS AmpliPrep/COBAS TaqMan CMV test, which is available commercially, and a laboratory-developed RT-PCR test) and one CMV pp65 antigenemia assay.
Materials and methods: A total of 49 samples from 32 transplant recipients (28 renal and 4 cardiac transplants) were submitted to these three methodologies.
Results: The results showed a significant agreement (concordance rates between 81.6% and 71.4%, and Cohen’s kappa coefficient values between 0.456 and 0.602, p < 0.001) and a moderate to high, significant (p < 0.01), correlation between these methods (Spearman’s coefficient value of 0.769 for pp65 antigenemia and COBAS, 0.546 for pp65 antigenemia and RT-PCR “in-house”, and 0.736 for COBAS and RT-PCR “in-house” comparison). The unexpected good results obtained with antigenemia is a consequence of decades of laboratory’s and operators’ experience with this technique. In addition, one third (33.3%) of all antigenemia positive samples had 1 or 2 positive cells.
Discussion and conclusions: The results from this study showed significant agreement and correlation between the three methodologies. Therefore, we conclude that these can be used successfully for monitoring solid organ transplant recipients.
Acknowledgements
We would like to thank the staff from microbiology laboratory, at the Egas Moniz Hospital, and the members of the microbiology department, at the Nova Medical School/Faculdade de Ciências Médicas, for collecting the data. The Authors have no conflicts of interest to declare.