Nucleic Acid Sequence-Based Amplification: A New Technique for Monitoring Cytomegalovirus Infection in Transplant Recipients

HE MAJORITY of the adult human population is infected with cytomegalovirus (CMV), a member of the b-herpesvirus family. Normally, infection of immunocompetent individuals does not cause disease. In contrast, infection of immunocompromised individuals, such as neonates, patients with AIDS, and transplant recipients, can cause severe complications and can even lead to death. Therefore, early detection of active CMV infection is necessary to start effective antiviral treatment. Nucleic acid sequence-based amplification (NASBA) has been developed for the specific amplification of RNA. 1 We evaluated the diagnostic value of monitoring the expression of the CMV immediate early (IE) 1 mRNA using NASBA, in peripheral blood cells of kidney and liver transplant patients. The IE 1 mRNA is expressed directly after entrance of the virus into a cell. NASBA results were compared to the techniques which are routinely being used for the detection of CMV: pp65-antigenemia, virus culture, and serology.