Understanding Viral Load Assays for Cytomegalovirus and Epstein-Barr Virus

Literature is Helpful But...

March 2010

There are a lot of interesting studies on CMV and EBV viral load testing in the literature. The problem is determining how best to apply the information to your local practice. It is essential to remember that any decision points or treatment guidelines that are published by various groups are HIGHLY dependent on the patient population, specimen analyzed, methodology, calibration used, and reporting units.

Although we cannot necessarily apply exact numbers or decision point levels from other studies, the literature can certainly be helpful in determining what concepts to consider when interpreting viral loads.

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Jump to section:

• Introduction
• 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?