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Open Access Research article

Pp65 antigenemia, plasma real-time PCR and DBS test in symptomatic and asymptomatic cytomegalovirus congenitally infected newborns

Sandro Binda1*, Antonella Mammoliti1, Valeria Primache1, Patrizia Didò1, Carlo Corbetta2, Fabio Mosca3, Lorenza Pugni3, Anna Bossi4, Cristian Ricci4 and Maria Barbi1

Author Affiliations

1 Dipartimento di Sanità Pubblica - Microbiologia - Virologia, Università degli Studi di Milano, Milan, Italy

2 Laboratorio di Riferimento Regionale per lo Screening Neonatale, AO ICP, Milan, Italy

3 Istituto di Pediatria e Neonatologia, Fondazione IRCCS "Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena", Università degli Studi di Milano, Milan, Italy

4 Istituto di Statistica Medica e Biometria "GA Maccacaro", Università degli Studi di Milano, Milan, Italy

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BMC Infectious Diseases 2010, 10:24  doi:10.1186/1471-2334-10-24

Published: 11 February 2010

Abstract

Background

Many congenitally cytomegalovirus-infected (cCMV) neonates are at risk for severe consequences, even if they are asymptomatic at birth. The assessment of the viral load in neonatal blood could help in identifying the babies at risk of sequelae.

Methods

In the present study, we elaborated the results obtained on blood samples collected in the first two weeks of life from 22 symptomatic and 48 asymptomatic newborns with cCMV diagnosed through urine testing. We evaluated the performances of two quantitative methods (pp65 antigenemia test and plasma Real-time PCR) and the semi-quantitative results of dried blood sample (DBS) test in the aim of identifying a valid method for measuring viral load.

Results

Plasma qPCR and DBS tests were positive in 100% of cases, antigenemia in 81%. Only the latter test gave quantitatively different results in symptomatic versus asymptomatic children. qPCR values of 103 copies/ml were found in 52% of newborn. "Strong" DBS test positivity cases had higher median values of both pp65 positive PBL and DNA copies/ml than cases with a "weak" positivity.

Conclusions

As expected antigenemia test was less sensitive than molecular tests and DBS test performed better on samples with higher rates of pp65 positive PBL and higher numbers of DNA copies/ml. The prognostic significance of the results of these tests will be evaluated on completion of the ongoing collection of follow-up data of these children.