Diagnostic value of antigenemia assay for cytomegalovirus gastrointestinal disease in immunocompromised patients

Table 1 Clinical factors for cytomegalovirus gastrointestinal disease (univariate analysis)

	CMV-GID (n = 52)	Non-CMV-GID (n = 47)	P-value
Age (yr, mean ± SD)	46.8 ± 16.2	56.6 ± 17.8	0.050
Male sex	30	41	0.098
Immunodeficiency disease
HIV infection	33	12	< 0.001
Malignancy	9	10	0.617
Solid cancer	1	3
Hematological cancer	8	7
Autoimmune disease	7	11	0.200
Disorders of biochemical homeostasis	8	11	0.312
Chronic renal failure	1	2
Liver cirrhosis	0	2
Diabetes mellitus	7	7
Transplantation	1	2
Immunosuppressive therapy	25	25	0.611
Steroids	22	19
Immunosuppressants	8	4
Chemotherapy	4	4
Positive CMV antigenemia	34	3	< 0.001
Leukopenia	35	21	0.023
With gastrointestinal symptoms	34	34	0.456

HIV: Human immunodeficiency virus; CMV: Cytomegalovirus; GID: Gastrointestinal disease.

Table 2 Diagnostic accuracy of cytomegalovirus antigenemia for detecting cytomegalovirus gastrointestinal disease

Subgroups	Sensitivity (95% CI)	Specificity (95% CI)	PPV (95% CI)	NPV (95% CI)
All patients (n = 99)	65.40% (55.4-74.9)	93.60% (87.3-97.7)	91.90% (84.7-96.4)	71.00% (60.7-79.4)
Patients with leukopenia (n = 56)	68.60% (54.0-79.7)	100% (93.6-100)	100% (93.6-100)	65.60% (52.2-78.2)
Patients without leukopenia (n = 43)	58.80% (42.1-73.0)	88.50% (74.9-96.1)	76.90% (61.4-88.2)	76.70% (61.4-88.2)
HIV-infected patients (n = 45)	63.60% (48.8-78.1)	100% (92.2-100)	100% (92.2-100)	50.00% (35.8-66.3)
Non-HIV-infected patients (n = 54)	68.40% (54.5-80.5)	91.40% (79.7-96.9)	81.30% (68.6-90.7)	84.20% (70.7-92.1)
HIV-infected patients with CD4 count < 50 (n = 22)	61.90% (40.7-82.8)	100% (84.6-100)	100% (84.6-100)	11.10% (1.12-29.2)
HIV-infected patients with CD4 count ≥ 50 (n = 23)	66.70% (42.7-83.6)	100% (85.2-100)	100% (85.2-100)	73.30% (51.6-89.8)

HIV: Human immunodeficiency virus; PPV: Positive predictive value; NPV: Negative predictive value.

Table 3 Comparison of diagnostic accuracy for detecting cytomegalovirus gastrointestinal disease between antigenemia assay and quantitative real-time polymerase chain reaction (n = 47)

	Sensitivity (95% CI)	Specificity (95% CI)	PPV (95% CI)	NPV (95% CI)
CMV real-time PCR	73.00% (57.4-84.4)	100% (92.5-100)	100% (92.5-100)	50.00% (36.1-65.9)
CMV antigenemia assay	64.90% (50.7-79.1)	100% (92.5-100)	100% (92.5-100)	43.50% (28.3-57.8)

CMV: Cytomegalovirus; PPV: Positive predictive value; NPV: Negative predictive value; PCR: Polymerase chain reaction.