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The detection of CMV specific IgM antibodies coupled with IgG antibodies of low avidity is taken as diagnostic of primary CMV infection. In a study of 64 pregnant women referred for avidity testing, six women were identified with bloods with positive IgM and low/equivocal avidity IgG on the Abbott Architect assay persisting over 18 weeks. Avidity increased to an "equivocal" level in two women over the course of follow up but remained "low" in four women. On repeat testing with the Diasorin Liaison assay, bloods from two women with low avidity with Architect gave high avidity results with Liaison. Blood from one woman giving low/equivocal results with Architect was reported as moderate avidity on repeat with Liaison. There is concern from these small numbers of cases that some women with positive IgM and low avidity IgG using the Abbott Architect assay may not have primary infections. This implies that they could be entered inappropriately into trials of experimental treatments aiming to prevent transmission of CMV to the fetus if the laboratory is asked to test patients for this purpose. It is suggested that larger series of patients should be examined to determine how frequently this phenomenon occurs.

Original publication

DOI

10.1002/jmv.23863

Type

Journal article

Journal

J Med Virol

Publication Date

05/2014

Volume

86

Pages

834 - 837

Keywords

avidity, congenital CMV, primary CMV, Antibodies, Viral, Antibody Affinity, Cytomegalovirus, Cytomegalovirus Infections, Diagnostic Errors, Female, Humans, Immunoglobulin G, Immunoglobulin M, Pregnancy, Pregnancy Complications, Infectious