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Standardization of Real-Time PCR to diagnose human cytomegalovirus reactivation and determine cutoff for preemptive treatment in receptors of hematopoietic stem cells

Grant number: 10/51154-0
Support type:Regular Research Grants
Duration: August 01, 2010 - January 31, 2013
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal researcher:Sandra Cecília Botelho Costa
Grantee:Sandra Cecília Botelho Costa
Home Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Considering the great impact that human cytomegalovirus (HCMV) may cause on patients submitted to hematopoietic stem cell transplantation (HSCT), the early diagnosis of this infection is highly important, by using sufficiently sensitive and specific laboratory techniques able to guide previous (preemptive) strategies in immunosuppressing patients. The antigenemia method is considered a great advance in diagnosis of this infection, and several studies indicate antigenemia as the gold standard to guide previous treatment in HSCT receptors. However, this method presents various disadvantages, such as the need for immediate sample processing, false-negative diagnoses in patients with severe neutropenia or medullary aplasia, among others. Conversely, real-time polymerase chain reaction (PCR) is emerging as an alternative to substitute antigenemia, and it may soon become the gold standard for monitoring this infection and its reactivation. However, the substitution from antigenemia to real-time PCR is not a simple task. First, it is necessary to choose the most appropriate protocol for this diagnosis, considering that the several protocols published are still not well-defined, resulting in different analytical performances and making it difficult to compare the results found in different studies, which present very contradictory cutoff values. Therefore, our study group will standardize and validate real-time PCR, aiming to further substitute antigenemia in the clinical routine of patients at the Bone Marrow Transplantation Unit - Hematology and Hemotherapy Center - University of Campinas (Hemocentro-Unicamp) and reduce the impact caused by HCMV. (AU)