Early diagnosis of CMV infection by detection of pp65 antigen in 91 renal transplant recipients

We evaluated how accurately a CMU antigenemia test correlated with classical CMU infection markers. We studied 91 kidney transplant recipients from February 1991 to June 1992. Antigenemia (pp65 antigen) was positive in 100% of cases of primary infection and in 70% of cases of reactivation and/or reinfection. Furthermore, antigenemia detected more infections (71%) than viremia (16%). The antigenemia test proved to be highly specific: it remained consistently negative in 22 seronegative patients, as well as in 19 of 20 seropositive recipients without recurrent infection. pp65 Antigen in the polymorphonuclear leukocytes was detected earlier than, or simultaneously with, virus culture in 78% of cases and became positive before serologic tests of primary and secondary infection in nearly 90% of cases. Most importantly, the antigenemia test detected all of the symptomatic cases.