Diagnosis and epidemiology of transfusion-associated human cytomegalovirus infection: recent developments.

OBJECTIVE

The prevention and diagnosis of transfusion-associated HCMV infection has to address different questions: Is the blood donor potentially infections? Is the transfused recipient undergoing an active primary or secondary infection?

DATA SOURCES: International literature (Current Contents Life Sciences) and reports of our study-group.

SELECTION CRITERIA: Original articles in English and German.

RESULTS

Monocytes have been identified as the major site of latency of human cytomegalovirus (HCMV) in peripheral blood. High seropositivity rates are observed in polytransfused individuals, intravenous drug users, organ transplant recipients, maintenance hemodialysis patients, homo/bisexuals and prostitutes. Although, there have been important developments in order to improve the sensitivity of the ELISAs for the diagnosis of active HCMV infection, serologic testing often fails to detect IgM and IgA antibodies in immunocompromised patients. Rapid virus isolation, structural antigen detection and DNA amplification by PCR in peripheral blood monocytes have considerably improved diagnosis of acute HCMV infection in neonates, organ transplant recipients and AIDS patients. Due to the low correlation of HCMV DNA detection and HCMV disease, PCR testing is actually not recommended for the monitoring of high risk patients and screening of infectiosity of blood components.

CONCLUSIONS

As a consequence numerous improvements in serological, virological and molecular methods, a more efficient prevention and diagnosis of transfusion-associated HCMV infection has become possible.