Bellomo-Brandao MA, Andrade PD, Costa SC, Escanhoela CA, Vassallo J, Porta G, De Tommaso AM, Hessel G. Cytomegalovirus frequency in neonatal intrahepatic cholestasis determined by serology, histology, immunohistochemistry and PCR. World J Gastroenterol 2009; 15(27): 3411-3416 [PMID: 19610143 DOI: 10.3748/wjg.15.3411]
Corresponding Author of This Article
Maria Angela Bellomo-Brandao, MD, PhD, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Aristides Lobo Street, 789. Campinas, São Paulo 13083-060, Brazil. bellomobrandao@globo.com
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World J Gastroenterol. Jul 21, 2009; 15(27): 3411-3416 Published online Jul 21, 2009. doi: 10.3748/wjg.15.3411
Cytomegalovirus frequency in neonatal intrahepatic cholestasis determined by serology, histology, immunohistochemistry and PCR
Maria Angela Bellomo-Brandao, Paula D Andrade, Sandra CB Costa, Cecilia AF Escanhoela, Jose Vassallo, Gilda Porta, Adriana MA De Tommaso, Gabriel Hessel
Maria Angela Bellomo-Brandao, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP 13083-970, Brazil
Paula D Andrade, Sandra CB Costa, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP 13083-970, Brazil
Cecilia AF Escanhoela, Jose Vassallo, Department of Pathology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP 13083-970, Brazil
Gilda Porta, Department of Pediatrics, Children’s Institute of Medical School of the University of São Paulo (USP), São Paulo-SP 05403-000, Brazil
Adriana MA De Tommaso, Gabriel Hessel, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas-SP 13083-970, Brazil
Author contributions: Bellomo-Brandao MA had responsibility for protocol development, laboratory investigation, preliminary data analysis and writing the manuscript; Andrade PD participated in the laboratory investigation; Vassallo J was responsible for immunohistochemistry tests; Porta G, De Tommaso AMA and Costa SCB participated in the development of the protocol; Escanhoela CAF was responsible for histological analysis; Hessel G conceived of the study, and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.
Correspondence to: Maria Angela Bellomo-Brandao, MD, PhD, Department of Pediatrics, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Aristides Lobo Street, 789. Campinas, São Paulo 13083-060, Brazil. bellomobrandao@globo.com
Telephone: +19-32874560
Fax: +19-35217193
Received: September 5, 2008 Revised: June 8, 2009 Accepted: June 15, 2009 Published online: July 21, 2009
Abstract
AIM: To determine cytomegalovirus (CMV) frequency in neonatal intrahepatic cholestasis by serology, histological revision (searching for cytomegalic cells), immunohistochemistry, and polymerase chain reaction (PCR), and to verify the relationships among these methods.
METHODS: The study comprised 101 non-consecutive infants submitted for hepatic biopsy between March 1982 and December 2005. Serological results were obtained from the patient’s files and the other methods were performed on paraffin-embedded liver samples from hepatic biopsies. The following statistical measures were calculated: frequency, sensibility, specific positive predictive value, negative predictive value, and accuracy.
RESULTS: The frequencies of positive results were as follows: serology, 7/64 (11%); histological revision, 0/84; immunohistochemistry, 1/44 (2%), and PCR, 6/77 (8%). Only one patient had positive immunohistochemical findings and a positive PCR. The following statistical measures were calculated between PCR and serology: sensitivity, 33.3%; specificity, 88.89%; positive predictive value, 28.57%; negative predictive value, 90.91%; and accuracy, 82.35%.
CONCLUSION: The frequency of positive CMV varied among the tests. Serology presented the highest positive frequency. When compared to PCR, the sensitivity and positive predictive value of serology were low.
