Understanding Viral Load Assays for Cytomegalovirus and Epstein-Barr Virus

Patients and Immunosuppression

March 2010

The context for our discussion is primarily transplant patients who, because of their state of immunosuppression, have an increased susceptibility to infections in general. I will be focusing the discussion today on CMV and EBV.

In broad terms, when considering the total risk of EBV or CMV infection, one must consider the net state of immunosuppression, including any immunosuppression drugs, antiviral drugs, and any cell growth drugs that the patient may be taking.

Transplant patients can be grouped into 2 main categories: recipients of solid organs and recipients of hematopoetic stem cells. It is important to understand that there are many details providing important points of differentiation within each group, but these considerations are outside the scope of this discussion.

< Previous Slide

Patients and Immunosuppression

Next Slide >

 

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?