HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (18) Citing Articles via Google Scholar Google Scholar Articles by Riise, G. C. Articles by Olofsson, S. Search for Related Content PubMed PubMed Citation Articles by Riise, G. C. Articles by Olofsson, S.

Quantification of Cytomegalovirus DNA in BAL Fluid^*

A Longitudinal Study in Lung Transplant Recipients

^* From the Departments of Respiratory Medicine (Dr. Riise), Infectious Diseases (Dr. Andersson), Virology (Drs. Bergström, Lundmark, and Olofsson), and Cardiothoracic Surgery (Dr. Nilsson), Sahlgrenska University Hospital, Göteborg, Sweden.

Correspondence to: Gerdt C. Riise, MD, PhD, Department of Respiratory Medicine, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden; e-mail gerdt.riise@hjl.gu.se

Study objectives: Cytomegalovirus (CMV) infection is common in patients receiving solid organ transplants, and it is associated with increased morbidity as well as risk for development of chronic rejection. A rapid and sensitive diagnostic method would improve the therapeutic management of CMV infection, including the monitoring of treatment effects. We investigated whether longitudinal determinations of CMV DNA quantities in BAL fluid could be useful for this purpose.

Design: CMV DNA levels in 340 BAL samples from 35 consecutive lung transplant recipients were studied during a median of 18 months. Seventeen (49%) of the patients developed CMV disease with pneumonitis. Twenty-seven CMV disease episodes were diagnosed.

Results: Patients with CMV disease had a significantly higher mean level of CMV copies per milliliter BAL fluid (1,120 ± 4,379) compared with those without (180 ± 1,177, p < 0.01). Viral load as well as acute rejection requiring treatment ( A2) were independent risk factors associated with CMV disease. Differences between the groups concerning HLA-DR matching, basic immunosuppressive therapy, and CMV serologic status D/R –/+ vs D/R +/+ were not significant. A diagnostic definition of normality based on the mean level of all episodes without CMV disease +2 SD would discriminate only 9 of the 27 CMV episodes.

Conclusions: Although the viral load is increased during episodes of clinical CMV disease in lung transplant recipients, the quantitative PCR assessment of CMV DNA in BAL fluid is not discriminative enough to be useful as a diagnostic tool for CMV disease.

Key Words: BAL • cytomegalovirus • lung transplantation • quantitative polymerase chain reaction

This article has been cited by other articles:

				R. F. Chemaly, B. Yen-Lieberman, E. A. Castilla, A. Reilly, S. Arrigain, C. Farver, R. K. Avery, S. M. Gordon, and G. W. Procop Correlation between Viral Loads of Cytomegalovirus in Blood and Bronchoalveolar Lavage Specimens from Lung Transplant Recipients Determined by Histology and Immunohistochemistry J. Clin. Microbiol., May 1, 2004; 42(5): 2168 - 2172. [Abstract] [Full Text] [PDF]