Journal Article

Predictive Value of Cytomegalovirus (CMV) Antigenemia and Digene Hybrid Capture DNA Assays for CMV Disease in Human Immunodeficiency Virus-Infected Patients

Sharon Walmsley, Keith O'Rourke, Clive Mortimer, Anita Rachlis, Ignatius Fong and Tony Mazzulli

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 3, pages 573-581
Published in print September 1998 | ISSN: 1058-4838
Published online September 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514703
Predictive Value of Cytomegalovirus (CMV) Antigenemia and Digene Hybrid Capture DNA Assays for CMV Disease in Human Immunodeficiency Virus-Infected Patients

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Oral ganciclovir prophylaxis decreases the incidence of cytomegalovirus (CMV) disease among persons infected with the human immunodeficiency virus (HIV), but universal prophylaxis is not cost-effective. We evaluated urine and peripheral blood mononuclear cell cultures, a qualitative and quantitative antigenemia assay, and a commercially available CMV DNA hybridization assay for their ability to predict CMV disease in 138 HIV-infected patients. During a median follow-up of 10 months, 23 patients (17%) developed CMV disease. The sensitivity, specificity, positive predictive value, negative predictive value, and mean lead times for the antigenemia assay (with use of a threshold of 8 positive cells per 105 peripheral blood mononuclear cells as a positive) were 74%, 91%, 63%, 95%, and 95 days, respectively. Corresponding figures for the DNA hybridization assay were 91%, 64%, 34%, 97%, and 152 days. These assays can identify patients at increased risk of CMV disease and should allow a strategy of preemptive therapy to be tested.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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