Prognostic value of quantitative-PCR versus serology for detection of CMV in pre- and post- transplantation patients

Two hundred-twenty six pre- and post- kidney transplantation patients were screened for CMV. They were categorized into three groups I: Eighty-five dialysis patients suffering from chronic renal failure, II: Sixty -two end stage renal disease patients prepared for transplantation, and III: Seventy-nine post-kidney transplant patients under immunosuppressive and cytotoxic therapy. The last group was subdivided according to clinical presentation into asymptomatic, mild, and invasive CMV disease subgroups. A control group comprised of fifty-two apparently healthy kidney and blood donors were also included. Serum and plasma samples were utilized for detection of anti-CMV antibodies by EIA, and determination of CMV viral load by quantitative-PCR respectively. QT-PCR results revealed high viral load; (4000-10.000 copy/ml) in 16 (100%) kidney recipient with invasive CMV disease, While only 4 (25%) of them were positive for IgM anti-CMV. Another ten patients with symptoms of CMV syndrome were found CMV-PCR positive with low viral load (436-3070 copy/ml) and all were negative for IgM anti-CMV. On the other hand, no CMV viral load was detectable among end-stage renal disease patients, although 6/62 (9.7%) were positive for IgM anti-CMV. All subjects were positive for IgG anti-CMV. It is concluded that QT-PCR rather than serology should be used for monitoring of CMV infection in pre- and post-transplantation patient.