Polymerase chain reaction of human cytomegalovirus from liver and urine compared with serological test in cholestasis infants

Keywords: Infant mortality, infectious disease, developing country, human cytomegalovirus

Abstract

Introduction: The most common infection in cholestatic infants is caused by human cytomegalovirus (HCMV). The aims were to detect the presentation of HCMV in cholestatic infants and to evaluate the concordance, sensitivity, and specificity between serology and polymerase chain reaction (PCR) of HCMV from liver biopsy and urine specimens.

Methodology: A descriptive observational study with a cross-sectional approach was conducted on 35 cholestatic infants with ethical approval. Specimens were liver biopsy, urine, and anti-HCMV serology. Liver and urine specimens were performed to nested PCR, followed by statistical analysis.

Results: PCR from the liver biopsy and urine specimen were positive in 74.3% and 85.7%, respectively. There was no concordance between IgM with the liver PCR, but there was a concordance between IgM with the urine PCR and between IgG with the liver and urine PCR. The sensitivity and specificity of IgM with the liver PCR were 46 % and 56%, respectively, with a diagnostic accuracy of 49%. While IgG sensitivity was 96% with a diagnostic accuracy of 80%. IgG sensitivity and IgM specificity compared with the urine PCR were 93% and 100%, respectively, with a diagnostic accuracy of more than 60%.

Conclusions: It demonstrates a high prevalence of HCMV DNA in urine and liver biopsy from cholestatic infants. HCMV PCR assay is more sensitive and specific than the anti-HCMV IgM, but IgG has high sensitivity and accuracy diagnostic. Therefore, serological examination is an option for diagnosing HCMV infection in cholestatic infants in developing countries with no PCR facilities.

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Author Biographies

Alphania Rahniayu, Department of Anatomic Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Department of Anatomic Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Gondo Mastutik, Department of Anatomic Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Department of Anatomic Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Anny Setijo Rahaju, Department of Anatomic Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Department of Anatomic Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Siti Eriaty Nur Ruslan, Institute of Tropical Diseases, Universitas Airlangga, Surabaya, Indonesia

Institute of Tropical Diseases, Universitas Airlangga, Surabaya, Indonesia

Priangga Adi Wiratama, Department of Anatomic Pathology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Department of Anatomic Pathology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Erna Sulistiyani, Department of Oral Medicine, Faculty Dentistry, Jember University, Jember, Indonesia

Department of Oral Medicine, Faculty Dentistry, Jember University, Jember, Indonesia

Bagus Setyoboedi, Department of Child Health, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Department of Child Health of Pediatric, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Published
2022-10-31
How to Cite
1.
Rahniayu A, Mastutik G, Rahaju AS, Ruslan SEN, Wiratama PA, Sulistiyani E, Setyoboedi B (2022) Polymerase chain reaction of human cytomegalovirus from liver and urine compared with serological test in cholestasis infants. J Infect Dev Ctries 16:1630-1636. doi: 10.3855/jidc.16851
Section
Original Articles