Article

Cytomegalovirus (CMV)

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Consistent CMV diagnostics testing for improved patient care

A widespread virus

Cytomegalovirus (CMV) is a common virus found in people of all ages - more than half of all adults have been infected by the age of 401. CMV is carried latently for life and can be reactivated.

 

There are three different types of cytomegalovirus infection that require CMV lab tests:

  • Congenital

  • Primary 

  • Reactivation

     

Roche diagnostics has made a commitment to deter the spread of CMV and is continuously monitoring the progression of CMV infections. We have the systems to accurately conduct CMV lab tests and help clinicians support their patients.

What is a CMV diagnosis test?

CMV can be dangerous to people with weakened immune systems due to conditions such as HIV or cancer. It can cause significant health problems in infants. CMV lab tests help identify the virus by checking for signs in the blood, sputum, or other body fluids.

Patient

Weakened immune systems are more susceptible

While the virus generally does not cause problems for those with healthy, functioning immune systems, it can have serious consequences for immunocompromised people. CMV diagnostics can spot the virus in people with weakened immune systems. The top risk groups include: 

 

  • Weakened immune systems due to HIV or cancer. 

  • Recently receivers of organ transplant

  • Pregnant women with symptoms 

  • New-borns with symptoms

     

Without an accurate CMV lab test, it becomes incredibly difficult to manage the infection and for clinicians to help patients. It is a virus that can spread quite quickly. It can be transmitted congenitally, through blood transfusion, organ transplantation, or through contact with bodily fluids, including urine, saliva, blood, genital secretions, and breast milk.

 

20%-60% of solid organ transplant recipients develop a symptomatic CMV infection, typically during the first few months after transplantation2. Patients can be infected through the donor organ, or the virus can be reactivated if previously present.

 

Biomedical Scientist

CMV diagnostics assays clinicians can rely on

Reactivation of CMV after a transplant can be detected quickly and treated using antiviral drugs. When it comes to successfully managing the infection and helping transplant patients enjoy long, healthy lives, consistency in test results plays a vital role.

 

Roche is committed to helping deter the spread and reactivation of CMV and provides WHO-standardised assays to detect and monitor the progression of CMV infections.

 

The different types of CMV lab tests

  • CMV lab test (older than 12 months)

The most widely available cytomegalovirus diagnosis tests from commercial laboratories are serologic tests that detect CMV antibodies (IgM and IgG). The Enzyme-Linked Immunosorbent Assay (ELISA) is the most common serologic test for measuring antibodies to CMV.

  • CMV diagnostics in newborns – Neonates

CMV in newborns is tested through Polymerase Chain Reaction (PCR) on saliva, with urine usually collected and tested for confirmation.

  • Transplantation

CMV IgG diagnosis testing is recommended before transplantation to assess CMV risk and guide posttransplant patient management. For patients 12 months or younger, Nucleic Acid Amplification Tests (NAATs) using an oral or urine specimen can help identify infection before transplantation.

  • Antiviral resistance

A cytomegalovirus diagnosis test can be warranted in certain situations to test for CMV resistance. This is done through genotypic methods. Next-Generation Sequencing (NGS) is a more sensitive method to detect resistant subpopulations than traditional Sanger sequencing.

Biomedical Scientist reporting results

Informing effective CMV management

CMV infection is a leading cause of morbidity and mortality in patients following transplantation. Calibrating and reporting CMV DNA viral load in International Units per millilitre (IU/mL) has improved the harmonisation of results from different laboratories.

 

Despite this, management of active CMV infection is still hampered by the limited commutability of results between reference materials and clinical samples, and a subsequent lack of evidence-based viral load thresholds.

 

CMV diagnostics: Clinician frequently asked questions

CMV diagnostics: Clinician frequently asked questions

The infection should be monitored on a weekly basis for three months after transplantation. Following-up is recommended for high-risk patients and those in which antiviral resistance is initiated.

Some variability still exists in test results due to aspects of testing such as platform, specimen type, and nucleic acid extraction method. Identical specimens may vary by greater than 10-fold when different platforms are used. Contact ROCHE Diagnostics for more information.

Screening for primary CMV infection is not currently recommended for pregnant individuals.

With improved techniques and Roche diagnostics' continuous monitoring of the virus, CMV lab tests for infections in newborn children are almost 90% accurate.

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    1. Centers for Disease Control and Prevention. Cytomegalovirus (CMV) and Congenital CMV infection. https://www.cdc.gov/cmv/

    2. Emovon, O.E., Baillie, G.M., Chavin, K.D. Infections after kidney transplantation. CME Coverage, based on Renal Week 2002: American Society of Nephrology 35th Annual Meeting.