Real Time Polymerase Chain Reaction versus Enzyme Linked Immunosorbent Assay in the Diagnosis of Cytomegalovirus Infection in Pregnant Women

Abstract

Background: Cytomegalovirus infection is endemic worldwide. Most frequently used methods for antibodies detection in developing world are enzyme linked immunosorbent assay. The polymerase chain reaction induces production of large amounts of specific deoxyribonucleic acid fragments from very low concentrations of complex substrates allowing detection of very low amounts of viral particles. Objectives: To assess the accuracy of ELISA test in comparison with the polymerase chain reaction in maternal blood to detect pregnant woman at high risk of CMV infection and transmission to the fetus. Study Design: Three hundred blood samples prospectively tested for CMV-specific IgG and IgM antibodies by using ELISA and for CMV DNA using real time PCR. Results: CMV IgG and IgM were present in 274(91.3) and 17(5.7%) sample respectively. However, CMV DNA was detected in 89 (29.7%) samples. Eighty-four tested samples exhibited both IgG by ELISA and DNA by Real-time PCR. Likewise, IgM was detectable by ELISA from 10 subjects with DNA concomitantly demonstrable by Real-time PCR. By comparison, IgG detected from 190 subjects, with no DNA detectable by Real-time PCR. Similarly, IgM present in seven samples tested by ELISA, but no DNA detected by Real-time PCR. Conclusion: This study demonstrated that the real time polymerase chain reaction test is more helpful for detection among pregnant woman who are at high risk of CMV infection and transmission to the fetus.