Diagnosis of Human Cytomegalovirus Infection: Laboratory Approaches

Summary

The association of cytomegalovirus (CMV) with a plethora of diseases and the recent development of potent anti-CMV compounds warrants the need for accurate verification of prior exposure to CMV as well as the identification of infectious virus in clinical specimens. This chapter initially reviews many of the traditional procedures used to detect CMV infections, including direct virus isolation and indirect immunological assays, for evidence of CMV infection. In so doing, procedures are outlined and the advantages and disadvantages of each method are discussed. Later, more detailed presentations of newer and, often, more sensitive procedures for CMV identification are given. Several of these approaches are designed to identify the presence of viral nucleic acid sequences in specimens by hybridization of probes to purified nucleic acids (Southern blotting) or directly to nucleic acids embedded in tissue sections (in situ hybridization). Also included here are significant discussion and instruction in the use of the polymerase chain reaction (PCR) and its application in identifying HCMV nucleic acid sequences in fresh and fixed specimens. Analysis of many of the advantages and disadvantages of using various reagents and samples is included. Finally, a brief description of virally associated cytomegalic cells in exfoliated and histological specimens is included in the hope that clinicians and laboratory scientists will be aware of a potential role for CMV in their diagnosis and prognosis of individual patients.