[Comparison of differents molecular methods for the detection of cytomegalovirus DNA in immunodepressed patients]. / Comparaison moléculaire de trois techniques de détection d'ADN du cytomégalovirus humain chez des immunodéprimés.

BACKGROUND: A Cytomegalovirus infection (HCMV) causes severe complications in immunosuppressed individuals (transplant recipients and AIDS patients). AIM: To detect the DNA of the HCMV by three molecular methods, and to identify the fastest method and most significant. METHODS: we tested 50 samples in order to detect the presence of the HCMV. This research was carried out by molecular Hybridization, the pp65 Antigenemia and PCR on the blood of the patients presenting an infection to CMV. RESULTS: Molecular hybridization is positive for 64%, Antigenemia is detected in 26 cases (50%) and the plasmatic PCR is positive in 13 cases (26%). These studies demonstrated that molecular hybridization permitted CMV detection of different biological liquid but Antigenemia and PCR techniques were used to determine of from leukocytes. Plasma-PCR and Hybridization assay presented the qualitatifs results. CONCLUSION: These studies indicate that there is a combining virological between molecular methods.

Comparison of pp65 antigenemia, quantitative PCR and DNA hybrid capture for detection of cytomegalovirus in transplant recipients and AIDS patients.

The cytomegalovirus (CMV) antigenemia assay has been used frequently for rapid diagnosis of CMV infection, and antigenemia threshold values are recommended for triggering preemptive therapy. Hybrid capture of CMV's DNA and quantitative polymerase chain reaction (qPCR) are increasingly being adopted for early detection of CMV. The performance of the antigenemia assay, qPCR in plasma and hybrid capture in leukocytes were compared in 110 immunocompromised patients (38 bone-marrow transplants, 50 renal transplants and 22 AIDS patients). The most sensitive test was hybrid capture for transplants, while antigenemia and the qPCR showed similar performance for patients with AIDS. QPCR and hybrid capture thresholds requiring antiviral therapy were calculated using a receiver-operating-characteristic curve for antigenemia values corresponding to 2 positive cells for bone-marrow transplants and to 10 positive cells for renal transplants and AIDS patients. These threshold values varied with the group of patients considered, with corresponding sensitivities higher than 86% and specificities higher than 76% for hybrid capture, and sensitivities higher than 61% and specificities higher than 75% for qPCR in plasma. Hybrid capture in leukocytes can substitute for antigenemia in the case of transplants, and qPCR in plasma can substitute for it in the case of AIDS patients.

Diagnostic value of PET-measured heterogeneity in myocardial blood flows during cold pressor testing for the identification of coronary vasomotor dysfunction.

BACKGROUND: We aimed to evaluate the diagnostic value of a positron emission tomography (PET)-measured heterogeneity in longitudinal myocardial blood flow (MBF) during cold pressor testing (CPT) and global MBF response to CPT from rest (DeltaMBF) for identification of coronary vasomotor dysfunction. METHODS AND RESULTS: In 35 patients CPT-induced alterations in epicardial luminal area were determined with quantitative angiography as the reference. MBF was assessed over the whole left ventricle as global MBF and regionally in the mid and mid-distal myocardium as MBF difference or MBF heterogeneity with nitrogen-13 ammonia and PET. The sensitivity and specificity of a longitudinal MBF difference during CPT in the identification of epicardial vasomotor dysfunction were significantly higher than the global DeltaMBF to CPT (88% vs 79% and 82% vs 64%, respectively; P < .05). Combining both parameters resulted in an optimal sensitivity of 100% at the expense of an intermediate specificity of 73%. The diagnostic accuracy was higher for the combined analysis than that for the MBF difference alone and global DeltaMBF alone (91% vs 86% and 74%, respectively; P < .05). CONCLUSIONS: The combined evaluation of a CPT-induced heterogeneity in longitudinal MBF and the change in global MBF from rest may emerge as a new promising analytic approach to further optimize the identification and characterization of coronary vasomotor dysfunction.

[Detection of DNA human cytomegalovirus of a molecular methods: hybrid capture DNA CMV by immunocompromised]. / Detection de l'adn du cytomegalovirus humain par hybridation moleculaire chez les immunodéprimés.

Human cytomegalovirus (HCMV), a member of the beta-virus herpes family, is a ubiquitous human pathogen. After a primary infection, HCMV establishes life latency. HCMV rarely causes symptomatic disease in an immunocompetent host, however, it is a major cause of infectious morbidity and mortality in immunocompromised individuals and developing fetuses. The HCMV genome consists of 240 kbp of double stranded DNA. Early diagnosis molecular of CMV infection is important. The objective of this study was to develop a molecular methods: Quantitative Hybrid capture for the detection of DNA CMV. We present results for 200 immunocompromised collected from 1999 to 2003 (122 men and 78 women, whom mean age was 35 years). Our results showed that 25% of women and 36% of men were positif for hybrid capture DNA CMV. This simple test (cold probe) provide quantitative and fast results. Also the efficacity of anti-CMV therapy can be followed. More over, in contrary with pp65-antigenemia assay and CMV PCR, this test can be managed on biopsy sample.