Correlation of PCR Results to Detect HCMV with Clinical Course of Kidney Transplant Recipients

Abstract

Peripheral blood leukocyte (PBL) specimens and urine specimens of 18 renal transplant patients were examined weekly or biweekly for the presence of human cytomegalovirus (HCMV), using polymelase chain reaction (PCR) technique, shell vial procedure and culture. In 11 out of 18 patients, HCMV was detected from either or both of PBL and urine within one to three months after transplantation. HCMV DNA was detected by PCR for a longer period of time, in comparison to the shell vial procedure, showing that PCR was more sensitive. However, only 3 patients showed symptomatic HCMV infection with pyrexia leukocytopenia and liver dysfunction, whose PBL and urine specimens were positive for HCMV by both of the methods. In these 3 patients, HCMV was detected for a longer period of time, whereas in the other asymptomatic patients, it was detectable for only one or two weeks. Moreover, using DNA obtained from PBL in symptomatic phase, HCMV major immediate early (MIE) gene was detected by PCR after amplification for fewer cycles, whereas DNA obtained from these 3 patients in the asymptomatic period or at the end to active HCMV infection, and from other asymptomatic patients, it was detectable after 30 cycles of amplification.