Understanding Viral Load Assays for Cytomegalovirus and Epstein-Barr Virus

Introduction

March 2010

Welcome to Mayo Medical Laboratories' Hot Topics. These presentations provide short discussion of current topics and may be helpful to you in your practice. Our presenter for this program is Dr. Thomas Grys, Associate Laboratory Director, Mayo Medical Laboratories New England, Department of Laboratory Medicine and Pathology at Mayo Clinic. Dr. Grys will discuss the utility of assays used to quantify Cytomegalovirus and Epstein-Barr virus. He will also describe the variability inherent to measuring a viral load, and how this must be considered when interpreting results in a clinical context.

In this hot topic, we will discuss assays used to quantify 2 viruses, Cytomegalovirus and Epstein-Barr virus. This is an area of active research, and there are a lot of details that affect both the measurement and interpretation of viral loads.

Introduction

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Jump to section:

• Cytomegalovirus and Epstein-Barr Virus Background
• Patients and Immunosuppression
• CMV in Transplant Patients
• When to Treat CMV?
• CMV Treatment Strategies
• EBV and Posttransplantation Lymphoproliferative Disorder
• When to Treat EBV?
• Treatment for EBV Infection or PTLD
• The Balancing Act of Transplant Immunology
• The Balancing Act of Transplant Immunology: Less immunosuppression
• The Balancing Act of Transplant Immunology: More immunosuppression
• The Balancing Act of Transplant Immunology
• Crucial Questions
• Viral Load Assays
• Viral Load Assays, cont.
• Variability
• Ideal Standards
• Comparing Results
• Logarithmic (log) Processes
• Advantages of Logarithmic (log) Numbers
• Integer, Scientific Notation, Logarithm
• Log vs Fold
• Disadvantages of Log
• Remember These?
• System Precision/Imprecision
• What is Significant Change?
• Reality Check
• Literature is Helpful But...
• Interpreting Viral Loads
• Review
• References
• Questions?