Diagnostic performance of cytomegalovirus (CMV) immune monitoring with ELISPOT and QuantiFERON-CMV assay in kidney transplantation: A PRISMA-compliant article

BACKGROUND: Cytomegalovirus (CMV) infection is part of major infection complications following kidney transplantation. However, more rapid and low-complexity assays are needed for CMV infection. Our study is to investigate the diagnostic efficacy of 2 novel tests, CMV-ELISPOT and QuantiFERON-CMV tests, in CMV DNA viremia and CMV infection following renal transplant. METHODS: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and the Web of Science. Case–control or cohort study designed to explore the CMV-ELISPOT and/or QuantiFERON-CMV tests in the recipients with CMV infection was considered to be eligible for this study. Sensitivity (SEN), specificity (SPE), diagnostic odds ratio (DOR), and summary receiver-operating characteristic (SROC) curves were calculated. RESULTS: We selected a total of 12 articles for systematic review and 11 of them were included in meta-analysis. For CMV-pp65 assay, the pooled SEN, SPE, and DOR were 0.73 (95% confidence interval [CI], 0.67–0.78), 0.61 (95% CI, 0.56–0.65), and 4.46 (95% CI, 3.11–6.39), respectively. For CMV-IE-1 assay, the pooled SEN, SPE, and DOR were 0.84 (95% CI, 0.78–0.88), 0.46 (95% CI, 0.42–0.51), and 5.07 (95% CI, 3.26–7.89), respectively, whereas the pooled SEN, SPE, and DOR of QuantiFERON-CMV test were 0.38 (95% CI, 0.28–0.49), 0.38 (95% CI, 0.32–0.44), and 1.02 (95% CI, 0.17–6.00). CONCLUSIONS: We reported that CMV-ELISPOT tests, including CMV-pp65 and CMV-IE-1, perform well in the diagnosis and prediction of CMV infection in renal transplant recipients, whereas QuantiFERON-CMV test needs further exploration.