58181:CYTOMEGALOVIRUS (CMV) ANTIBODIES, IgG & IgM

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58181:CYTOMEGALOVIRUS (CMV) ANTIBODIES, IgG & IgM
Alias Names: CMV Antibodies, IgG & IgM / CMV Panel
Methodology: Enzyme-Linked Immunosorbent Assay (ELISA)
Edit Date: 8/1/2006
Performed: Tuesday
Released: Same day
CPT Code: 86644 / 86645
Specimen Collection Details
Collection: One 7.5 mL serum separator tube (SST). Also acceptable: One 5 mL red top tube.
Handling: Allow to clot, centrifuge and separate serum from cells immediately. Refrigerate. Freeze at -20° C if specimen cannot be assayed within 48 hours. Allow no more than one freeze/thaw cycle.
Standard Volume: 0.5 mL serum.
Minimum Volume: 200 µL serum.
Transport: Refrigerated, or frozen on dry ice.
Comments: See also: Torch Antibodies, IgG & IgM (58961).
Rejection Criteria: Plasma; heat inactivation; gross lipemia or gross hemolysis; bacterial contamination; specimen that has been frozen and thawed more than once; refrigerated specimen received in laboratory more than 48 hours after collection.

CMV Antibody, IgG: <0.9 IV (IV = Index Value)
CMV Antibody, IgM: <0.9 IV
Cytomegalovirus (CMV) IgG Antibody Result Interpretation, ELISA Method:
<0.9 IV Negative: No significant level of detectable CMV IgG antibody.
0.9-1.0 IV Equivocal: Repeat testing in 10-14 days may be helpful.
≥ 1.1 IV Positive: IgG antibody to CMV detected which may indicate current or previous CMV infection.
Cytomegalovirus (CMV) IgM Antibody Result Interpretation, ELISA Method:

Seroconversion between acute and convalescent sera is considered strong evidence of current or recent infection. The best evidence for infection is a significant change on two appropriately timed specimens, where both tests are done in the same laboratory at the same time.

<0.9 IV Negative: No significant level of detectable CMV IgM antibody.
0.9-1.0 IV Equivocal: Repeat testing in 10-14 days may be helpful.
≥ 1.1 IV Positive: IgM antibody to CMV detected, which may indicate a current or recent infection.
IV = Index Value

Appearance of IgM antibody response normally occurs 7-14 days after onset of disease. Testing immediately post-exposure is of no value without a later convalescent specimen. While the presence of IgM antibodies suggests current or recent infection, low levels of IgM antibodies may occasionaly persist for more than 12 months post-infection. Such a residual IgM response may be distinguished from early IgM response to infection by testing sera from patients 2-3 weeks later for changing levels of specific IgM antibodies.

IgM responses may vary in different individuals. It has been reported that 10-30% of infants may fail to develop IgM antibody responses despite congenital CMV infection. Furthermore, up to 27% of adults with primary CMV infection may not demonstrate an IgM response. In immunocompromised patients, CMV serology may not be reliable and may be misleading in the diagnosis of acute or reactivation CMV disease.