الفهرس | Only 14 pages are availabe for public view |
Abstract Human cytomegalovirus (HCMV) is the most important pathogen affecting renal transplant recipients, causing significant morbidity and mortality. Sensitive and specific assays are required for defining patients at risk for CMV disease especially with the development of effective anti-CMV treatment, Ganciclovir. Diagnostic techniques for HCMV detection have greatly improved during the recent years. In immunocompromised patients, sensitive techniques are needed to diagnose HCMV infections which is, sometimes, difficult to interpret. The aim of this work is to evaluate rapid means for early diagnosis of HCMV infection among renal transplant recipients who are clinically suspected to have active CMV infection, so that efficient treatment can be administered at the proper time. Also to correlate the diagnostic techniques with clinical data. The present study was carried on 120 renal transplant recipients who were clinically suspected to have CMV disease. In addition, 20 normal individuals were participated as control group. Urine, throat swabs, and serum samples were collected. Urine and throat swab samples were subjected to CMV early Ag. detection by indirect immunoflourescence (IFA) directly and onto MRC-5 monolayers 24 hours post inoculation. Serum samples were subjected to PCR and anti CMV (low avidity IgG and IgM). There was an agreement between shell vial assay and both direct Ag. detection and PCR in diagnosis of CMV infection. Also, there was a strong agreement between CMV low avidity IgG and shell vial assay in diagnosis of CMV infection as regard percentage of total positive and negative results. There was an agreement between CMV low avidity IgG and both direct Ag. detection and PCR. On the other hand, there was no agreement between CMV IgM and each of shell vial assay, direct Ag. detection, PCR and CMV low avidity IgG. In this study, there were 5 patients presenting with chronic allograft nephropathy (CAN) among 10 patients with CMV disease. The shell vial assay, PCR, and low avidity IgG was the most sensitive assay for detection of positive cases, detected 5 out of 5 (100%) compared to 4 out of 5 (80%) detected by direct Ag. detection and CMV IgM assays. |