The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Clinical Significance of Low Cytomegalovirus DNA Levels in Human Plasma
Open accessAbstract
The clinical significance of the detection of low copy numbers of cytomegalovirus (CMV) DNA in immune-suppressed patients remains unclear. In this study, we compared the artus CMV Rotor-Gene PCR, utilizing an automated nucleic acid extraction and assay setup (the artus CMV protocol), with the COBAS Amplicor CMV Monitor test (our reference protocol). We then analyzed the results of all CMV PCR tests ordered following the implementation of the artus CMV protocol at our institution and followed 91 adult patients with positive test results. The artus CMV protocol had a linear range extending from 2.0 to 7.0 log(10) copies/ml and had a lower limit of 95% detection of 57 copies/ml. With archived plasma samples, this protocol demonstrated 100% sensitivity and 94% specificity for the detection of CMV DNA. Following implementation of the artus CMV protocol, 320 of 1,403 (22.8%) plasma samples tested positive (compared with 323/3,579 [9.0%] samples in the preceding 6 months), and 227 (16.2%) samples had copy numbers of <400/ml. Ninety-one adult patients had at least one positive test. The data were analyzed using a threshold of 200 copies/ml, and in 22 episodes, the viral load increased from <200 copies/ml to ≥ 200 copies/ml on sequential tests. In 21 of these 22 episodes, either the viral load continued to increase or antiviral treatment was initiated in response to the repeat value. In summary, we evaluate the performance characteristics of a protocol utilizing the artus CMV PCR and identify clinically meaningful changes in CMV DNA copy numbers even when they are initially detected at a low level.
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The FilmArray ME panel limit of detection for CMV was 4300 copies/ml, compared to 57 copies/ml for the Artus CMV PCR assay.
“The LOD of the FilmArray ME panel for CMV was 4300 copies/ml, far in excess of 57 copies/ml for the Artus CMV PCR assay (Qiagen, Hilden, Germany) performed in the NVRL [20].”
From Outcomes of implementation of the FilmArray meningoencephalitis panel in a tertiary hospital between 2017 and 2020. (2022) · cites this paper as [20]
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Research works printed but not linked: 2
- Argene, Inc. 2012. CMV R-gene product information. Argene, Inc., Shirley, NY.
- College of American Pathologists. 2011. VLS-A, viral load participant summary. Surveys and Anatomic Pathology Education Programs, Northfield, IL.
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Teoh, T., Powell, J., O’Keeffe, J., Donlon, E., Dillon, L., Lenihan, M., Mostyn, A., Power, L., Boers, P., Stapleton, P. J., et al. (2022) · PloS One · doi:10.1371/journal.pone.0265187 · Cited by 7
“103 CSF samples were referred to the NVRL, including confirmatory testing of viral targets in eight positive specimens, and a further 95 FilmArray-negative specimens were sent based on clinical suspicion of viral meningoencephalitis despite a negative FilmArray ME panel result, with particular emphasis on corroborator…”
MethodInfluential
Metadata
- Authors
- Waggoner, J., Ho, D. Y., Libiran, P., & Pinsky, B. A.
- Affiliations
- Stanford Medicine (US)
- Venue
- Journal of Clinical Microbiology
- Publisher
- American Society for Microbiology
- Published
- 2012-07
- Volume
- 50
- Issue
- 7
- Pages
- 2378-2383
- ISSN
- 0095-1137 (ISSN-L)
- 1098-660X
- PMC
- PMC3405616
- OpenAlex
- W2007125953
- Cited by
- 38
- References
- 21
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 4 · 2018: 2 · 2017: 2 · 2016: 5 · 2015: 3 · 2014: 4 · 2013: 4 · 2012: 3
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Microbiology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Cytomegalovirus and herpesvirus research
- Health Sciences › Medicine › Infectious Diseases › Herpesvirus Infections and Treatments
- Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
- Keywords
- cytomegalovirus, low viral load, immunocompromised patients, viral load threshold, antiviral treatment initiation
- MeSH terms
- Adult, Aged, Automation, Cytomegalovirus Infections, Cytomegalovirus, DNA, Viral, Female, Humans, Male, Middle Aged, Plasma, Sensitivity and Specificity, Virology, Immunocompromised Host, Viral Load, Molecular Diagnostic Techniques
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