Which type of underlying disease facilitates cytomegalovirus infection? Comparison of benign disease, hematopoietic malignancy, and post-bone-marrow or renal transplantation status by using the first standardized objective PCR test for cytomegalovirus detection.
All immunocompromised hosts, such as infants, the elderly, patients with advanced cancer, and patients being treated with immunosuppressants, etc., are said to be more susceptible to cytomegalovirus (CMV) infection or CMV disease. However, we questioned the validity of this conclusion and attempted to detect CMV viremia in the plasma of subjects by using the AMPLICOR CMV test (Roche Diagnostics Systems, Branchburg, NJ), the first standardized PCR kit for CMV infection. One hundred healthy volunteers whose CMV IgG titer was < 4 and 100 healthy volunteers whose IgG titer for CMV was > or = 4 were studied. None of the subjects in either healthy group was positive for CMV viremia. Patients who were suspected of CMV infection were divided into four groups and tested: [1] 104 patients with benign disease, only one of whom was positive for CMV [2] 99 patients with hematopoietic malignancy who had not undergone bone marrow transplantation and all of whom were negative for CMV infection [3] 120 post-bone-marrow transplantation, 28 of whom were CMV positive, [4] 37 post-renal transplantation patients, 19 of whom were CMV positive. A statistically significant difference in CMV positivity was found by the non-parametric Kruskal-Wallis test (p < 0.0001) among the four disease group. CMV infection has been said to occur in all types of immunocompromised patients, however, based on our findings, we conclude that CMV infection tends to occur in post-transplantation status and does not tend to occur in patients with hematopoietic malignancy if they have not undergone transplantation.