Table 2.

Diagnostic testing for CMV

MethodSpecimen(s)aComments
SerologyBloodNot helpful in diagnosing CMV infection or disease in transplant recipients because of delayed seroconversion; good for pretransplantation evaluation to assess the likelihood of reactivation infection (if positive) or susceptibility to primary infection (if negative)
Conventional tube cell cultureBlood, tissue, urine, BAL, CSFb Long (1–3 wk) turnaround time; cytotoxicity occasionally precludes viral isolation; used for viral isolation for antiviral susceptibility testing
Shell vial assayBlood, tissue, urine, BAL, CSFb Rapid (1–2 days); positive result from blood implies active CMV infection
Antigenemia assayBloodRapid (same day); requires little laboratory support; more sensitive than shell vial assay, less sensitive than PCR; quantitative results
HistopathologyTissueDetects viral inclusion bodies; insensitive marker of CMV disease; sensitivity enhanced with immunostaining; requires use of invasive procedures to obtain sample
In situ DNA hybridizationTissueb Confirmation of tissue involvement with CMV
PCR amplificationBlood, tissue, urine, BAL, CSFb Detects viral DNA and/or RNA; extremely sensitive, but not specific for symptomatic infection; allows quantitation of viral load; not standardized
Hybrid capture assayBlood, tissueb Rapid; detects viral DNA; less sensitive than PCR
bDNA assayBlood, CSFb Less sensitive than PCR; highly reproducible
NASBABlood, tissueb Detects viral RNA; highly sensitive; investigational
  • a Abbreviations: BAL, bronchoalveolar lavage fluid; CSF, cerebrospinal fluid.

  • b Other bodily fluids and clinical specimens may also be amenable for testing.