Monitoring human cytomegalovirus infection in pediatric hematopoietic stem cell transplant recipients: using an affordable in‐house qPCR assay for management of HCMV infection under limited resources |
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| Authors: | Behzad Khansarinejad Hoorieh Soleimanjahi Siamak Mirab Samiee Amir Ali Hamidieh Mahdi Paryan Yadollah Sanahmadi Manoochehr Karami Mahdieh Mondanizadeh |
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| Affiliation: | 1. Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran;2. Department of Microbiology and Immunology, Arak University of Medical Sciences, Arak, Iran;3. Food and Drug Laboratory Research Center, Ministry of Health and Medical Education, Tehran, Iran;4. Hematology‐Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran;5. Department of Research and Development, Production and Research Complex, Pasteur Institute of Iran, Tehran, Iran;6. Day General Hospital Laboratory, Tehran, Iran;7. Department of Biostatistics and Epidemiology, Hamadan University of Medical Sciences, Hamadan, Iran;8. Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran |
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| Abstract: | Quantitative real‐time PCR (qPCR) assay is accepted as the method of choice for monitoring human cytomegalovirus (HCMV) infection in hematopoietic stem cell transplant recipients, but the high cost of commercial kits has hampered its use in many developing countries. In this study, an affordable in‐house qPCR was used to manage HCMV infection in pediatric patients and the diagnostic value of this method was compared with the conventional pp65 antigenemia assay. A total number of 1179 samples from 82 recipients were used in this study, and the effect of some potential risk factors on HCMV reactivation was evaluated. The qPCR was able to detect HCMV reactivation earlier and with higher sensitivity than antigenemia assay. Forty‐six episodes of reactivation were detected in 39 patients, of which all were detected by the qPCR assay, while only 21 episodes were diagnosed by antigenemia. The DNAemia level of 1284 IU/ml plasma was defined as the optimal cutoff value for starting pre‐emptive therapy. It was shown that the acute GVHD severity and the relationship of donor and recipient are the most significant risk factors for HCMV reactivation. The data suggest that the antigenemia method for monitoring HCMV reactivation could be substituted by the qPCR assay. |
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| Keywords: | antigenemia cytomegalovirus pediatric pp65
qPCR
transplantation |
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