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HelpTest Code CMVP Cytomegalovirus (CMV) Antibodies, IgM and IgG, Serum
Reporting Name
Cytomegalovirus Ab, IgM and IgG, SUseful For
Aiding in the diagnosis of acute or past infection with cytomegalovirus (CMV)
Determining prior exposure to CMV
This test should not be used for screening blood or plasma donors.
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| CMVM | Cytomegalovirus Ab, IgM, S | Yes | Yes |
| CMVG | Cytomegalovirus Ab, IgG, S | Yes | Yes |
Method Name
Multiplex Flow Immunoassay (MFI)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Aliquot tube
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Specimen Minimum Volume
0.8 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 14 days | |
| Frozen | 14 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
| Gross icterus | Reject |
| Heat-inactivated specimen | Reject |
Reference Values
CYTOMEGALOVIRUS IgM:
Negative
CYTOMEGALOVIRUS IgG:
Negative
Reference values apply to all ages.
Day(s) Performed
Monday through Saturday
CPT Code Information
86644-CMV, IgG
86645-CMV, IgM
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CMVP | Cytomegalovirus Ab, IgM and IgG, S | 87424-8 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CMVG | Cytomegalovirus Ab, IgG, S | 13949-3 |
| CMVM | Cytomegalovirus Ab, IgM, S | 24119-0 |
Clinical Information
Cytomegalovirus (CMV) is a member of the Herpesviridae family of viruses and usually causes asymptomatic infection after which it remains latent in patients, primarily within bone marrow derived cells. Primary CMV infection in immunocompetent individuals may manifest as a mononucleosis-type syndrome, similar to primary Epstein-Barr virus infection, with fever, malaise and lymphadenopathy.
CMV is a significant cause of morbidity and mortality among bone marrow or solid organ transplant recipients, individuals with AIDS, and other immunosuppressed patients due to virus reactivation or from a newly acquired infection. Infection in these patient populations can affect almost any organ and lead to multiorgan failure. CMV is also responsible for congenital disease among newborns and is one of the TORCH infections (toxoplasmosis, other infections including syphilis, rubella, CMV, and herpes simplex virus).
CMV seroprevalence increases with age. In the United States, the prevalence of CMV-specific antibodies increases from approximately 36% in children from 6 to 11 years old to over 91% in adults over 80 years old.
Interpretation
IgM:
A negative cytomegalovirus (CMV) IgM result suggests that the patient is not experiencing acute or active infection. However, a negative result does not rule-out primary CMV infection.
It has been reported that CMV-specific IgM antibodies were not detectable in 10% to 30% of cord blood sera from infants demonstrating infection in the first week of life. In addition, up to 23% (3/13) of pregnant women with primary CMV infection did not demonstrate detectable CMV IgM responses within 8 weeks postinfection. In cases of primary infection where the time of seroconversion is not well defined, as high as 28% (10/36) of pregnant women did not demonstrate CMV IgM antibody.
Positive CMV IgM results indicate a recent infection (primary, reactivation, or reinfection). IgM antibody responses in secondary (reactivation) CMV infections have been demonstrated in some CMV mononucleosis patients, a few pregnant women, and kidney and cardiac transplant patients. Levels of antibody may be lower in transplant patients with secondary rather than primary infections.
IgG:
Positive CMV IgG results indicate past or recent CMV infection. These individuals may transmit CMV to susceptible individuals through blood and tissue products.
Individuals with negative CMV IgG results are presumed to not have had prior exposure or infection with CMV and are, therefore, considered susceptible to primary infection.
Equivocal CMV IgM or IgG results may occur during acute infection or may be due to nonspecific binding reactions. Submit an additional specimen for testing if clinically indicated.
Cautions
Sera collected very early during the acute stage of infection may have undetectable levels of cytomegalovirus (CMV) IgM or IgG.
Immunocompromised patients may have impaired immune responses and nonreactive IgM/IgG results may be due to delayed seroconversion and, therefore, do not rule out current infection.
The CMV IgM and IgG results should not be used alone to diagnose CMV infection. Results should be considered in conjunction with clinical presentation, patient history and other laboratory findings. In cases of suspected disease, submit a second specimen for testing in 10 to 14 days.
The performance characteristics of these assays have not been evaluated in immunosuppressed patients or organ transplant recipients and have not been established for cord blood or for testing of neonates.
Immune complexes or other immunoglobulin aggregates present in patient specimens may cause increased nonspecific binding and produce false-positive results.
Potential cross-reactivity for CMV IgM may occur with specimens positive for Epstein-Barr virus viral capsid antigen IgM and parvovirus B19 IgM.
Potential cross-reactivity for CMV IgG with human chorionic gonadotropin, HIV IgG, multiple myeloma IgG, rheumatoid factor IgM, and Toxoplasma gondii IgG have not be ruled out.
Method Description
The BioPlex 2200 cytomegalovirus (CMV) IgM and IgG assays use multiplex flow immunoassay technology. Briefly, CMV antigen-coated fluorescent beads are mixed with an aliquot of patient sample and sample diluent and then incubated at 37° C. During this time, IgM and IgG anti-CMV antibodies in the specimen bind to the CMV antigen on the beads. After a wash cycle, a fluorescently labeled antihuman IgM- and IgG-antibody conjugate is added to the mixture and incubated at 37° C. Following a wash step to remove unbound conjugate, the bead mixture is passed through a detector that identifies the bead based on dye fluorescence and determines the amount of antibody captured by the antigen based on fluorescence of the antihuman-IgG conjugate. Raw data is calculated in relative fluorescence intensity and is converted to an antibody index for interpretation. Antibody index (AI) values of 0.8 and lower are considered negative. AI values of 0.9 and 1.0 are equivocal. AI values of 1.1 and above are considered positive. Three additional dyed beads, an internal standard bead, a serum verification bead, and a reagent black bead are present in each reaction mixture to verify detector response, the addition of serum to the reaction vessel and the absence of significant nonspecific binding in serum, respectively.(Package inserts: BioPlex 2200 System, ToRC IgG. Bio-Rad Laboratories; 03/2012; ToRC IgM. Bio-Rad Laboratories; 08/2017)