CMV DNA Viral load by Real Time PCR - EDTA Plasma

Bacterial/ Viral

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No Fasting Required

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Quantifies CMV viral load.

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CMV DNA Viral Load by Real Time PCR - EDTA Plasma

Why is it done?
- Test Purpose: Detects and quantifies cytomegalovirus (CMV) DNA in blood plasma using real-time polymerase chain reaction (PCR) technology to measure viral load and assess active CMV infection
- Primary Indications: Diagnosis and monitoring of CMV infection in immunocompromised patients (HIV/AIDS, transplant recipients); assessment of CMV disease severity; monitoring treatment response to antiviral therapy; detection of CMV reactivation in high-risk populations
- Clinical Circumstances: Performed during acute symptomatic episodes; routine monitoring in post-transplant patients; baseline assessment before immunosuppressive therapy; follow-up testing during antiviral treatment; investigation of fever, retinitis, esophagitis, pneumonitis, or neurological symptoms in immunocompromised individuals
Normal Range
- Reference Range: Negative or < 150 copies/mL (varies by laboratory; some labs report < 500 copies/mL as negative)
- Units of Measurement: Copies/mL or log10 copies/mL (logarithmic scale used for expressing high viral loads)
- Detection Limit: Typically 50-150 copies/mL; values below this are reported as 'Not Detected' or 'Negative'
- Interpretation: Negative/Not Detected = No active CMV viral replication; Positive = Presence of CMV DNA indicating active infection; Higher values indicate greater viral burden and increased disease risk
Interpretation
- Negative/Not Detected: No detectable CMV DNA; indicates absence of active CMV viremia; suggests effective viral control or successful antiviral therapy; common in immunocompetent individuals
- Low Positive (150-1,000 copies/mL): Early viral replication or controlled infection; warrants close monitoring; may indicate CMV reactivation in transplant recipients or HIV-positive patients; evaluate clinical symptoms and CD4+ count
- Moderate Positive (1,000-10,000 copies/mL): Active CMV infection requiring clinical attention; suggests risk of CMV disease development; antiviral therapy is typically recommended; frequent monitoring essential
- High Positive (>10,000 copies/mL): High viral burden indicating significant active CMV infection; high risk of CMV disease; requires immediate antiviral intervention and intensive monitoring; associated with organ involvement (retinitis, esophagitis, pneumonitis)
- Factors Affecting Results: CD4+ count level (critical below 50 cells/μL in HIV); immune status; effectiveness of antiretroviral therapy; antiviral drug prophylaxis or treatment; viral strain variation; specimen handling and timing; presence of resistance mutations
- Clinical Significance Patterns: Rising trend indicates disease progression and breakthrough infection; Declining trend suggests treatment response; Persistently elevated levels indicate antiviral resistance; Serial monitoring more informative than single test
Associated Organs
- Primary Organ Systems: Immune system (lymphocytes); blood and vascular system (endothelium); retina and eye (anterior chamber); gastrointestinal tract (esophagus, stomach, colon); respiratory system (lungs); central nervous system (brain); renal system
- CMV Disease Manifestations: CMV Retinitis (hemorrhagic retinitis with vision loss); CMV Esophagitis (dysphagia, odynophagia); CMV Pneumonitis (respiratory failure); CMV Colitis (diarrhea, bloody stools); CMV Encephalitis (dementia, cognitive changes); CMV Polyradiculopathy (lower extremity weakness); CMV Hepatitis; CMV Myocarditis
- Associated Medical Conditions: Advanced HIV/AIDS (CD4+ <50 cells/μL); Solid organ transplantation (kidney, heart, liver, lung); Bone marrow/hematopoietic stem cell transplantation; Severe immunosuppressive therapy; Congenital CMV infection; Immunocompromised neonates
- Potential Complications: Permanent vision loss from retinitis; Gastrointestinal perforation and hemorrhage; Acute respiratory distress syndrome; Neurological sequelae and cognitive impairment; Acute organ rejection; Secondary bacterial infections; Death from overwhelming viral dissemination; Immune recovery uveitis (IRU)
Follow-up Tests
- Recommended Follow-up Testing: Repeat CMV DNA PCR in 1-2 weeks to assess trend; CD4+ T lymphocyte count and percentage; HIV RNA viral load; CMV resistance testing (ganciclovir/foscarnet resistance mutations) if persistent viremia despite therapy; CMV serology (anti-CMV IgG/IgM antibodies)
- Organ-Specific Investigations: Ophthalmologic examination with dilated fundoscopy (CMV retinitis); Upper endoscopy with biopsy (CMV esophagitis); High-resolution CT chest (CMV pneumonitis); Colonoscopy with biopsy (CMV colitis); Lumbar puncture with CSF CMV PCR (CMV encephalitis); EMG/NCS (CMV polyradiculopathy)
- Immunological Testing: Complete metabolic panel and liver function tests; Renal function assessment; Hematologic parameters (CBC); HLA typing and panel reactive antibody (transplant recipients); Immunosuppressant drug levels
- Monitoring Frequency: Post-transplant: Weekly to monthly (depends on protocol); HIV with CD4+ <50: Monthly screening; On antiviral therapy: Baseline, week 2, week 4, then monthly; Post-immune reconstitution: Baseline then annually
- Complementary Tests: CMV antigenemia (pp65 antigen); Blood cultures (exclude bacterial superinfection); Histopathology with CMV immunostaining; In situ hybridization; Other viral panel (EBV, HHV-6, HHV-8, VZV, HSV)
Fasting Required?
- Fasting: No
- Patient Preparation: No specific preparation required; can be drawn at any time of day; patient may eat and drink normally; no dietary restrictions
- Specimen Collection Requirements: EDTA (ethylenediaminetetraacetic acid) plasma tube (lavender or purple top) required; 3-5 mL blood draw; avoid hemolyzed or lipemic specimens; collect in sterile container; process promptly to maintain DNA integrity
- Specimen Handling: Keep specimen at room temperature if processing within 4 hours; refrigerate (2-8°C) if delay anticipated; avoid freezing unless necessary; maintain chain of custody; label clearly with patient identification and collection time
- Medications: No medications need to be held before specimen collection; antiviral medications do not interfere with test accuracy; anticoagulants (other than EDTA) should not be used
- Special Instructions: Inform laboratory of immunocompromised status; document CD4+ count if HIV-positive (prognostic indicator); note current antiviral therapy; indicate urgency if symptomatic; specify if testing for prophylactic monitoring vs. diagnostic purposes

How our test process works!