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Meta-Analysis
. 2019 Apr;98(16):e15228.
doi: 10.1097/MD.0000000000015228.

Diagnostic performance of cytomegalovirus (CMV) immune monitoring with ELISPOT and QuantiFERON-CMV assay in kidney transplantation: A PRISMA-compliant article

Yashi Ruan  1 , Wei Guo, Sudong Liang, Zhen Xu, Tianli Niu
Affiliations
Meta-Analysis

Diagnostic performance of cytomegalovirus (CMV) immune monitoring with ELISPOT and QuantiFERON-CMV assay in kidney transplantation: A PRISMA-compliant article

Yashi Ruan et al. Medicine (Baltimore). 2019 Apr.

Abstract

Background: Cytomegalovirus (CMV) infection is part of major infection complications following kidney transplantation. However, more rapid and low-complexity assays are needed for CMV infection. Our study is to investigate the diagnostic efficacy of 2 novel tests, CMV-ELISPOT and QuantiFERON-CMV tests, in CMV DNA viremia and CMV infection following renal transplant.

Methods: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Web of Science. Case-control or cohort study designed to explore the CMV-ELISPOT and/or QuantiFERON-CMV tests in the recipients with CMV infection was considered to be eligible for this study. Sensitivity (SEN), specificity (SPE), diagnostic odds ratio (DOR), and summary receiver-operating characteristic (SROC) curves were calculated.

Results: We selected a total of 12 articles for systematic review and 11 of them were included in meta-analysis. For CMV-pp65 assay, the pooled SEN, SPE, and DOR were 0.73 (95% confidence interval [CI], 0.67-0.78), 0.61 (95% CI, 0.56-0.65), and 4.46 (95% CI, 3.11-6.39), respectively. For CMV-IE-1 assay, the pooled SEN, SPE, and DOR were 0.84 (95% CI, 0.78-0.88), 0.46 (95% CI, 0.42-0.51), and 5.07 (95% CI, 3.26-7.89), respectively, whereas the pooled SEN, SPE, and DOR of QuantiFERON-CMV test were 0.38 (95% CI, 0.28-0.49), 0.38 (95% CI, 0.32-0.44), and 1.02 (95% CI, 0.17-6.00).

Conclusions: We reported that CMV-ELISPOT tests, including CMV-pp65 and CMV-IE-1, perform well in the diagnosis and prediction of CMV infection in renal transplant recipients, whereas QuantiFERON-CMV test needs further exploration.

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Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Results of quality assessment across studies evaluated by QUADAS-2.
Figure 3
Figure 3
Results of diagnostic meta-analysis for overall CMV immune monitoring in kidney transplantation, including the pooled sensitivity (A), specificity (B), diagnostic odds ratio (C), and SROC curve (D).
Figure 4
Figure 4
Results of diagnostic meta-analysis for CMV-pp65 assay in kidney transplantation, including the pooled sensitivity (A), specificity (B), diagnostic odds ratio (C), and SROC curve (D).
Figure 5
Figure 5
Results of diagnostic meta-analysis for CMV-IE-1 assay in kidney transplantation, including the pooled sensitivity (A), specificity (B), diagnostic odds ratio (C), and SROC curve (D).
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