Cytomegalovirus IgM antibody detection: comparison of five assays

Human Cytomegalovirus (CMV) infection can result in a dramatic disease in immunosuppressed patients. For effective treatment sensitive and specific procedures are required for prompt and early diagnosis of active CMV infection. In the present study five different serological assays were used for detection of CMV-specific immunoglobulin M antibodies (IgM) in 78 sera, obtained from patients with a clinical suspicion of CMV infection. In addition, sequential sera, obtained from renal transplant recipients who experienced a primary CMV infection, were analysed by the five IgM detection assays. The assays used were two enzyme-linked immunosorbent assays (ELISA): the Vironostika CMV ELISA from Organon Teknika (ELISA-1) and the Monosan CMV ELISA from Sanbio (ELISA-2), the CMV microparticle enzyme immunoassay (MEIA) from Abbott and two Western-(immuno)blotting techniques using purified CMV structural viral proteins of the AD169 strain (IB-AD169) and the major non structural DNA binding protein of 52 kiloDalton (IB-Rp52) as antigenic material. The results of the assays were compared to each other with respect to sensitivity, specificity and overall agreement, as well as incidence of false positive and false negative results. Although the MEIA gave the highest sensitivity, the ELISA-1 combined a high sensitivity with a high specificity and therefore appears the most suitable method for determination of active CMV infection.