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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).
See this image and copyright information in PMC

References

    1. Noble J, Gatault P, Sautenet B, et al. Predictive factors of spontaneous CMV DNAemia clearance in kidney transplantation. J Clin Virol 2017;99-100:38–43. - PubMed
    1. Fishman JA, Emery V, Freeman R, et al. Cytomegalovirus in transplantation—challenging the status quo. Clin Transplan 2007;21:149–58. - PubMed
    1. Fishman JA. Infection in renal transplant recipients. Semin Nephrol 2007;27:445–61. - PubMed
    1. Humar A, Michaels M. Monitoring AIWGoID. American Society of Transplantation recommendations for screening, monitoring and reporting of infectious complications in immunosuppression trials in recipients of organ transplantation. Am J Transplant 2006;6:262–74. - PubMed
    1. Hodson EM, Ladhani M, Webster AC, et al. Antiviral medications for preventing cytomegalovirus disease in solid organ transplant recipients. Cochrane Database Syst Rev 2013;2: CD003774. - PubMed

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