Quantitative PCR for early detection of human cytomegalovirus end-organ disease in immunocompetent host: A retrospective single-center study

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES Journal of Infection and Public Health Pub Date : 2024-09-16 DOI:10.1016/j.jiph.2024.102542
Cheon-Hoo Jun , Si-Ho Kim , Junyoung Kim , Kwang Min Kim , Jung Won Lee , Sung Min Kong , Jiyeong Kwak , Byung Soo Kwan , Hyun Kyu Cho , Kyoung-Jin Park , Hyoung Tae Kim , Yu Mi Wi
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Abstract

Background

Tissue-invasive end-organ disease (EOD) caused by cytomegalovirus (CMV) is less frequently reported in immunocompetent patients compared to immunocompromised patients. In this study, we investigated the association between CMV viremia and CMV end-organ disease in immunocompetent patients.

Methods

Adult patients (≥18 years old) with CMV viremia were screened from January 2010 to June 2022. The primary outcome was the presence of CMV EOD. Risk factors associated with CMV EOD were analyzed, and a receiver operating characteristic curve was plotted to determine the most accurate cutoff value of the CMV titer for the prediction of CMV EOD.

Results

Among the 106 immunocompetent patients with CMV viremia, 31 exhibited CMV EOD. Gastrointestinal tract disease was the most common. The log10 value of the CMV titer was significantly associated with the occurrence of CMV EOD in immunocompetent patients with CMV viremia. The optimal cut-off CMV titer for the prediction of CMV EOD was 749 IU/mL.

Conclusions

Our study suggests the potential association between high CMV titers and the development of CMV end-organ diseases and describes the diagnostic performance and utility of quantitative PCR as a surrogate marker for predicting the occurrence of CMV EOD in immunocompetent patients.

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定量 PCR 用于早期检测免疫功能正常宿主的人类巨细胞病毒终末器官疾病:一项回顾性单中心研究
背景巨细胞病毒(CMV)引起的组织侵袭性内脏疾病(EOD)在免疫功能正常患者中的报道少于免疫功能低下患者。在这项研究中,我们调查了免疫功能正常患者的 CMV 病毒血症与 CMV 内脏疾病之间的关联。方法:2010 年 1 月至 2022 年 6 月期间,我们对有 CMV 病毒血症的成人患者(≥18 岁)进行了筛查。主要结果是出现 CMV EOD。分析了与CMV EOD相关的风险因素,并绘制了接收者操作特征曲线,以确定预测CMV EOD最准确的CMV滴度临界值。胃肠道疾病最为常见。在 CMV 病毒血症的免疫功能正常患者中,CMV 滴度的 log10 值与 CMV EOD 的发生显著相关。结论:我们的研究表明,高CMV滴度与CMV终末器官疾病的发生可能存在关联,并描述了定量PCR作为替代标记物预测免疫功能正常患者发生CMV EOD的诊断性能和效用。
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来源期刊
Journal of Infection and Public Health
Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
13.10
自引率
1.50%
发文量
203
审稿时长
96 days
期刊介绍: The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.
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