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Corresponding Author

nagy, abdalrahman

Document Type

Original Article

Abstract

Background: Primary cytomegalovirus (CMV) illness is underdiagnosed in clinical practice, particularly in the setting of fever of unexplained origin (FUO). CMV IgM can last for months after original infection, and can be positive in reactivated CMV infections.The IgG avidity of (CMV) is a useful tool for identifying people who have recently been infected. IgG avidity matures over six months after primary infection .Low CMV IgG avidity predicts recent infection within the previous 3 to 4 months, but high avidity rules out the main infection within the last 3 months. Objective: To determine concordance between Anti-CMV IgM ELISA and IgG Avidity Testing of Serum Immunoglobulin in FUO Patients. Patient and method: This was a retrospective cross-sectional study of 170 patients who presented with FUO and were admitted to the inpatient section of a military fever hospital; all included patients underwent routine laboratory and imaging examinations.56 patients were tested to evaluate the CMV IgM and IgG avidity tests. Results: Out of 56 patients tested, 10 patients (17.9%) were CMV-IgM positive, 6 patients (60%) of them were CMV low avidity, and 4 patients (40%) were CMV high avidity, which indicates that most patients with CMV IgM positive tests had significant low avidity tests. 21.4% of patients were positive as regards the CMV avidity test. The degree of concordance between CMV IgM positive patients and CMV avidity according to kappa agreement was 44%. Conclusion: Our findings show the critical relevance of incorporating CMV-IgG avidity into the CMV primary infection screening criterion.

Keywords

CMV (cytomegalovirus); FUO (fever of unknown origin); IgG-avidity

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