[Comparison of Two Commercial Quantitative Cytomegalovirus (CMV) Polymerase Chain Reaction Tests Calibrated by World Health Organization International CMV Standard]
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[Comparison of Two Commercial Quantitative Cytomegalovirus (CMV) Polymerase Chain Reaction Tests Calibrated by World Health Organization International CMV Standard]
Cytomegalovirus (CMV) viral load quantitation is important in the diagnosis, follow-up and monitoring of antiviral therapy in transplant patients. In this study, aiming to compare the results of two Health Organization Commercial (WHO) International CMV standard calibrated test polymerase chain reaction, CMV Cobas Ampliprep / Cobas TaqMan (CMV-CAP / CTM) (Roche, Germany) and Artus CMV QIASymphony-Rotorgene (CMV-QS-RGQ) (Qiagen, Germany).
Both tests were performed simultaneously on 244 plasma samples. The result is measured in copies / ml and converted to IU / ml by multiplying by 0.91 for CMV-CAP / CTM and 1.64 for CMV-QS-RGQ, as specified by the manufacturer. CMV DNA was detected in 174 (71.3%) and was not detected in 52 (21.3%) of the samples and eighteen (7.4%) samples had discordant results of the two tests. In 16 of 18 samples with irregularities, viral load under dynamic measuring range of both tests.
In one sample, CMV DNA could not be detected by CMV-CAP / CTM but detected by CMV-QS-RGQ with 497 copies / ml, and 334 copies / ml of CMV DNA was detected by CMV-CAP / CTM in another sample where it is can not be detected by CMV-QS-RGQ. A high degree of agreement was found between the qualitative results of both tests (kappa = 0.80, p <0.001). For quantitative results in a dynamic measurement range of the second test (n = 129), the values of the median viral load was measured with the CMV-CAP / CTM and CMV-QS-RGQ was 1140 copies / ml (range: 151-254000) and 1826 copies / ml (range: 189-551521).
When the results are converted to IU / ml, the values of the median viral load was measured with the CMV-CAP / CTM and CMV-QS-RGQ is 1037 IU / ml (range: 137-231140) and 2993 IU / ml (range: 310- 904 133 ), each. There is a very strong correlation (r = 0.94, p <0.001; r = 0.94, p <0.001, respectively) between the values of log10 of the quantitative results in a dynamic measuring range (n = 129) as copy / ml and IU / ml of the second test. CMV-values in accordance with the QS-RGQ 150, 1000, 3000 copies / ml in CMV-CAP / CTM is as 94.5, 1571, 323.5 copies / ml and values of CMV-QS-RGQ in accordance with 137, 910 , 2730 IU / ml in CMV CAP / CTM is as 154, 2557.6, 6965.9 IU / ml, respectively. A variation of 0.45 log 10 is determined between these values.
[Comparison of Two Commercial Quantitative Cytomegalovirus (CMV) Polymerase Chain Reaction Tests Calibrated by World Health Organization International CMV Standard]
In total 131 samples; 129 of them with the results of both tests in the dynamic measurement range and two of them were CMV DNA was not detected in any of the tests; found that 112 (85.5%) results for copy / ml, 73 (56%) results to IU / ml is within ± 0.5 log10 difference measurements and 19 (14.5%) results for copy / ml and 58 ( 44%) results to IU / ml greater than ± 0.5 log10. Bland-Altman analysis demonstrated that CMV test-CAP / CTM make measurements are lower than CMV-QS-RGQ and the average difference for copy / ml and IU / ml results of 0.22 log10 copies / ml and 0.47 log10 IU / ml.
In conclusion; when the results are converted to IU / ml, the number of samples with acceptable measurement difference between the results of two tests (≤ 0.5 log10) decrease and the number of samples with different measurements of> 0.5 log10 increase and the difference was found to be statistically significant (p <0.001 ). Calibrating Roche CMV CAP / CTM and Artus test CMV-QS-RGQ with WHO international CMV standard does not enhance the comparability between the quantitative results in plasma samples, on the contrary, it was found that when the results are converted to IU / ml, the difference measurements showed viral replication significant biological detected between the two tests.
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This case highlights the unusual presentation of extra-pulmonary TB and the importance of EUS-guided FNA in diagnosing TB suspected pancreatic mass and potential malignant unnecessary surgical resection.
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