Key result
A diagnostic algorithm using CMV-IgM detection followed by CMV-IgG avidity index failed to date infection in only 1% of cases, compared to 26% when using CMV-IgG avidity index alone.
Why the study?
Does CMV-IgM detection followed by CMV-IgG avidity measurement improve the dating of primary CMV infection compared to CMV-IgG avidity measurement alone in pregnant women?
Observational (n=310)
Does CMV-IgM detection followed by CMV-IgG avidity measurement improve the dating of primary CMV infection compared to CMV-IgG avidity measurement alone in pregnant women?
For diagnosing primary CMV infection in pregnant women, detecting CMV-IgM antibodies first followed by measuring CMV-IgG avidity index is superior to measuring avidity alone.
Answers are grounded in this paper and cite their sources.
May improve dating of primary CMV infection in pregnancy; hypothesis-generating and requires prospective validation before practice change.
OBJECTIVES: Serological diagnosis of CMV primary infection is usually based on the detection of specific IgM antibody. However, as the presence of IgM antibody is not always correlated with primary infection, measurement of IgG avidity must be performed. The aim of our study was to evaluate the best procedure for serological diagnosis of CMV primary infection. In other words, is it better to first search for IgM antibody, and, if positive, then measure IgG avidity, or first measure IgG avidity without the detection of IgM antibody? MATERIALS: CMV-IgM detection and CMV-IgG avidity measurement were performed on 310 IgG positive sera from pregnant women. RESULTS: CMV-IgM antibody was detected positive for 9 of 310 sera. Using CMV-IgG avidity index (AI), dating of infection was difficult in 81/310 cases (26%), while it failed in only 3/310 cases using CMV-IgM plus CMV-IgG AI. CONCLUSION: The diagnosis of primary CMV infection can be based on the detection of CMV-IgM antibody first and then on the measurement of CMV-IgG AI.
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Macé et al. (2004) conducted an observational in Primary CMV infection (n=310). CMV-IgM detection followed by CMV-IgG avidity measurement vs. CMV-IgG avidity measurement alone was evaluated on Difficulty or failure in dating of infection. A diagnostic algorithm using CMV-IgM detection followed by CMV-IgG avidity index failed to date infection in only 1% of cases, compared to 26% when using CMV-IgG avidity index alone.
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