Infect Chemother.  2016 Dec;48(4):302-308. 10.3947/ic.2016.48.4.302.

Sensitivity of the Cytomegalovirus Antigenemia Assay to Diagnose Cytomegalovirus Retinitis

• Hong SI
• Kim T
• Park SY
• Jung J
• Lee JY
• Chong YP
• Sung H
• Lee SO
• Choi SH
• Kim YS
• Woo JH
• Kim SH

• KMID: 2441324
• DOI: http://doi.org/10.3947/ic.2016.48.4.302

Abstract

BACKGROUND
Cytomegalovirus (CMV) retinitis is one of the most important tissue-invasive CMV diseases in immunocompromised patients. Since 1980, non-invasive diagnostic methods, notably the CMV antigenemia assay, have been widely used as adjunct tests to diagnose tissue-invasive CMV diseases. However, there are limited data on the diagnostic value of the CMV antigenemia assay for diagnosing CMV retinitis.
MATERIALS AND METHODS
We performed a retrospective review of all cases of CMV retinitis at Asan Medical Center, Seoul, South Korea over a 9-year period. The diagnosis of CMV retinitis was made by experienced ophthalmologists according to medical history and an ophthalmoscopic appearance of typical retinopathy, together with absence of an alternative diagnosis.
RESULTS
We analyzed 44 patients with CMV retinitis (affecting 57 eyes) for whom the CMV antigenemia assay was performed. Of the 44 patients, 31 (70%) were HIV-uninfected and 13 (30%) were HIV-infected. The overall sensitivity of the CMV antigenemia assay was 66% (95% confidence interval [CI] 50-80%). The test's sensitivity showed a non-significant trend towards being higher in HIV-infected patients than in HIV-uninfected patients (sensitivity 85% vs 58%, respectively, P = 0.16). In a subgroup analysis of the 35 patients without other concurrent tissue-invasive CMV disease, the sensitivity of the CMV antigenemia assay was 57% (95% CI 40-74%).
CONCLUSIONS
The CMV antigenemia assay has limited value as a non-invasive diagnostic adjunct test for CMV retinitis. Therefore, the results of the assay need to be interpreted in the context of underlying disease, clinical presentation, and ophthalmoscopic findings.

Keyword

Cytomegalovirus; Retinitis; Diagnosis; Test

MeSH Terms

Chungcheongnam-do
Cytomegalovirus Retinitis*
Cytomegalovirus*
Diagnosis
Humans
Immunocompromised Host
Korea
Retinitis
Retrospective Studies
Seoul

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