Diagnosis of cytomegalovirus infection in HIV-infected patients with respiratory disease
Background: The role of the cytomegalovirus (CMV) in the respiratory morbidity and mortality of HIV-infected patients remains unclear. This is due in part to difficulties in making an accurate and rapid diagnosis. There has been a limited number of studies, often with few or no AIDS patients, on the...
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Published in | Clinical and diagnostic virology Vol. 10; no. 1; pp. 1 - 7 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Shannon
Elsevier B.V
01.05.1998
Elsevier Science |
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Abstract | Background: The role of the cytomegalovirus (CMV) in the respiratory morbidity and mortality of HIV-infected patients remains unclear. This is due in part to difficulties in making an accurate and rapid diagnosis. There has been a limited number of studies, often with few or no AIDS patients, on the use of DNA–DNA in situ hybridization (ISH) and polymerase chain reaction to diagnose CMV respiratory infection directly on bronchoalveolar fluid samples.
Objectives: To compare the centrifugation culture (CC), ISH, and nested-primer polymerase chain reaction (npPCR) techniques on bronchoalveolar fluid for the diagnosis of respiratory CMV infection.
Study design: Samples were obtained prospectively from a group of 35 HIV-infected homosexual men evaluated for pneumonia at a university hospital. Sensitivity, specificity, and predictive values of the three techniques were measured and compared, using the conventional roller tube cell culture (CRTC) as the gold standard.
Results: Sensitivity, specificity, positive and negative predictive values were as follows: 86%, 86%, 90%, and 80% for the CC; 5%, 100%, 100%, and 41% for ISH; and 86%, 57%, 75%, and 73% for npPCR. Of the six false positive samples by npPCR, two were positive by CC (none by ISH). If the latter were considered true positives, the specificity and positive predictive values of npPCR would increase to 67% and 83%, respectively.
Conclusions: CC appeared to be the best of the three techniques compared in this study for diagnosis of respiratory CMV infection in HIV-infected patients. The sensitivity and predictive values of DNA–DNA ISH were very poor. Results with npPCR were acceptable, and this technique may be considered in situations when rapid diagnosis of CMV infection is necessary. |
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AbstractList | The role of the cytomegalovirus (CMV) in the respiratory morbidity and mortality of HIV-infected patients remains unclear. This is due in part to difficulties in making an accurate and rapid diagnosis. There has been a limited number of studies, often with few or no AIDS patients, on the use of DNA-DNA in situ hybridization (ISH) and polymerase chain reaction to diagnose CMV respiratory infection directly on bronchoalveolar fluid samples.
To compare the centrifugation culture (CC), ISH, and nested-primer polymerase chain reaction (npPCR) techniques (npPCR) techniques on bronchoalveolar fluid for the diagnosis of respiratory CMV infection.
Samples were obtained prospectively from a group of 35 HIV-infected homosexual men evaluated for pneumonia at a university hospital. Sensitivity, specificity, and predictive values of the three techniques were measured and compared, using the conventional roller tube cell culture (CRTC) as the gold standard.
Sensitivity, specificity, positive and negative predictive values were as follows: 86%, 86%, 90%, and 80% for the CC; 5%, 100%, 100%, and 41% for ISH; and 86%, 57%, 75%, and 73% for npPCR. Of the six false positive samples by npPCR, two were positive by CC (none by ISH). If the latter were considered true positives, the specificity and positive predictive values of npPCR would increase to 67% and 83%, respectively.
CC appeared to be the best of the three techniques compared in this study for diagnosis of respiratory CMV infection in HIV-infected patients. The sensitivity and predictive values of DNA-DNA ISH were very poor. Results with npPCR were acceptable, and this technique may be considered in situations when rapid diagnosis of CMV infection is necessary. BACKGROUNDThe role of the cytomegalovirus (CMV) in the respiratory morbidity and mortality of HIV-infected patients remains unclear. This is due in part to difficulties in making an accurate and rapid diagnosis. There has been a limited number of studies, often with few or no AIDS patients, on the use of DNA-DNA in situ hybridization (ISH) and polymerase chain reaction to diagnose CMV respiratory infection directly on bronchoalveolar fluid samples. OBJECTIVESTo compare the centrifugation culture (CC), ISH, and nested-primer polymerase chain reaction (npPCR) techniques (npPCR) techniques on bronchoalveolar fluid for the diagnosis of respiratory CMV infection. STUDY DESIGNSamples were obtained prospectively from a group of 35 HIV-infected homosexual men evaluated for pneumonia at a university hospital. Sensitivity, specificity, and predictive values of the three techniques were measured and compared, using the conventional roller tube cell culture (CRTC) as the gold standard. RESULTSSensitivity, specificity, positive and negative predictive values were as follows: 86%, 86%, 90%, and 80% for the CC; 5%, 100%, 100%, and 41% for ISH; and 86%, 57%, 75%, and 73% for npPCR. Of the six false positive samples by npPCR, two were positive by CC (none by ISH). If the latter were considered true positives, the specificity and positive predictive values of npPCR would increase to 67% and 83%, respectively. CONCLUSIONSCC appeared to be the best of the three techniques compared in this study for diagnosis of respiratory CMV infection in HIV-infected patients. The sensitivity and predictive values of DNA-DNA ISH were very poor. Results with npPCR were acceptable, and this technique may be considered in situations when rapid diagnosis of CMV infection is necessary. Background: The role of the cytomegalovirus (CMV) in the respiratory morbidity and mortality of HIV-infected patients remains unclear. This is due in part to difficulties in making an accurate and rapid diagnosis. There has been a limited number of studies, often with few or no AIDS patients, on the use of DNA–DNA in situ hybridization (ISH) and polymerase chain reaction to diagnose CMV respiratory infection directly on bronchoalveolar fluid samples. Objectives: To compare the centrifugation culture (CC), ISH, and nested-primer polymerase chain reaction (npPCR) techniques on bronchoalveolar fluid for the diagnosis of respiratory CMV infection. Study design: Samples were obtained prospectively from a group of 35 HIV-infected homosexual men evaluated for pneumonia at a university hospital. Sensitivity, specificity, and predictive values of the three techniques were measured and compared, using the conventional roller tube cell culture (CRTC) as the gold standard. Results: Sensitivity, specificity, positive and negative predictive values were as follows: 86%, 86%, 90%, and 80% for the CC; 5%, 100%, 100%, and 41% for ISH; and 86%, 57%, 75%, and 73% for npPCR. Of the six false positive samples by npPCR, two were positive by CC (none by ISH). If the latter were considered true positives, the specificity and positive predictive values of npPCR would increase to 67% and 83%, respectively. Conclusions: CC appeared to be the best of the three techniques compared in this study for diagnosis of respiratory CMV infection in HIV-infected patients. The sensitivity and predictive values of DNA–DNA ISH were very poor. Results with npPCR were acceptable, and this technique may be considered in situations when rapid diagnosis of CMV infection is necessary. |
Author | C. Hogg, James Hayashi, Shizu de la Hoz, Rafael E Cook, Darrel Byrne, Sean K Christopher Sherlock |
Author_xml | – sequence: 1 givenname: Rafael E surname: de la Hoz fullname: de la Hoz, Rafael E organization: University of British Columbia Respiratory Medicine Program, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada – sequence: 2 givenname: Sean K surname: Byrne fullname: Byrne, Sean K organization: British Columbia Center for Disease Control, 828 West 10th Avenue, Vancouver, BC V5Z 1L8, Canada – sequence: 3 givenname: Shizu surname: Hayashi fullname: Hayashi, Shizu organization: University of British Columbia Pulmonary Research Laboratory, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada – sequence: 4 surname: Christopher Sherlock fullname: Christopher Sherlock organization: Diagnostic Virology and Reference Laboratory and Department of Pathology, University of British Columbia and St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada – sequence: 5 givenname: Darrel surname: Cook fullname: Cook, Darrel organization: British Columbia Center for Disease Control, 828 West 10th Avenue, Vancouver, BC V5Z 1L8, Canada – sequence: 6 givenname: James surname: C. Hogg fullname: C. Hogg, James organization: University of British Columbia Pulmonary Research Laboratory, St. Paul's Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada |
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CitedBy_id | crossref_primary_10_1186_s40560_022_00615_6 crossref_primary_10_1016_S1386_6532_02_00091_4 crossref_primary_10_1016_S0873_2159_15_30884_9 crossref_primary_10_1016_j_resinv_2022_05_003 |
Cites_doi | 10.1016/0166-0934(91)90043-Y 10.1099/00222615-46-3-188 10.1056/NEJM199104113241501 10.1093/ajcp/87.6.766 10.1182/blood.V81.7.1909.1909 10.1093/infdis/150.2.272 10.1093/infdis/155.3.501 10.1016/S0890-8508(06)80011-3 10.1093/infdis/166.6.1223 10.1093/infdis/158.6.1177 10.1093/infdis/166.6.1408 10.1155/1996/689094 10.1128/JCM.27.11.2429-2432.1989 10.1378/chest.92.2.198 10.1128/JCM.31.6.1435-1438.1993 10.1378/chest.88.6.856 10.1164/ajrccm/139.6.1531 10.1006/mcpr.1994.1039 10.7326/0003-4819-102-6-747 10.1093/clinids/12.Supplement_7.S737 10.1093/infdis/164.3.488 10.1128/JCM.31.10.2824-2827.1993 |
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Keywords | Cytomegalovirus CC, centrifugation culture Pneumonia HIV, human immunodeficiency virus npPCR, nested-primer polymerase chain reaction Acquired immunodeficiency syndrome LDH, lactate dehydrogenase Polymerase chain reaction PCP, Pneumocystis carinii pneumonia CMV, cytomegalovirus PCR, polymerase chain reaction Human immunodeficiency virus CRTC, conventional roller tube culture In situ hybridization ISH, in situ hybridization Human Immunopathology Opportunistic infection Respiratory disease Herpesviridae AIDS Method Betaherpesvirinae Immune deficiency Human cytomegalovirus Infection Virus Viral disease Diagnosis Comparative study |
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Snippet | Background: The role of the cytomegalovirus (CMV) in the respiratory morbidity and mortality of HIV-infected patients remains unclear. This is due in part to... The role of the cytomegalovirus (CMV) in the respiratory morbidity and mortality of HIV-infected patients remains unclear. This is due in part to difficulties... BACKGROUNDThe role of the cytomegalovirus (CMV) in the respiratory morbidity and mortality of HIV-infected patients remains unclear. This is due in part to... |
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SubjectTerms | Acquired immunodeficiency syndrome Adult AIDS-Related Opportunistic Infections - diagnosis AIDS-Related Opportunistic Infections - virology AIDS/HIV Biological and medical sciences Bronchoalveolar Lavage Fluid - virology Cytomegalovirus Cytomegalovirus - genetics Cytomegalovirus - isolation & purification Cytomegalovirus Infections - diagnosis Cytomegalovirus Infections - virology Human immunodeficiency virus Human viral diseases Humans In situ hybridization Infectious diseases Male Medical sciences Middle Aged Pneumonia Pneumonia, Viral - diagnosis Pneumonia, Viral - virology Polymerase chain reaction Polymerase Chain Reaction - methods Prospective Studies Sensitivity and Specificity Viral diseases Viral diseases of the respiratory system and ent viral diseases |
Title | Diagnosis of cytomegalovirus infection in HIV-infected patients with respiratory disease |
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