Background: To evaluate the utility of blood, saliva and urine samples as virological markers of cytomegalovirus infection in liver and heart transplant recipients.
Patients and method: Patients (68 liver, 21 heart) with a minimum follow up of two months after the transplant date, were included. We performed tube and shell vial cultures in all types of samples. In addition, cytomegalovirus antigenemia assay was carried out on blood specimens.
Results: A 97.2% of 36 patients with cytomegalovirus active infection were detected by using blood samples, in comparison with the 86.1% by saliva and 63.9% by urine, but differences were only statistically significant when considering the liver transplant patients subgroup. Moreover, blood samples allowed to detect the infection a mean of 19 days earlier than detection in saliva and/or urine. The most sensitive technique in blood was the antigenemia assay (94.7% of infected patients), followed by the shell vial method (85.3%) and conventional culture (73.3%). The former yields earlier results than culture methods, with a mean of 5 days.
Conclusions: Cytomegalovirus detection in blood samples showed a higher sensitivity in comparison with detection in urine and/or saliva, and was an earlier marker of infection in these patients. We recommended the antigenemia assay and the shell vial culture in blood samples because of their sensitivity, rapidity, and simplicity.