Is It Possible to Determine Plasma Cytomegalovirus DNA Cut-off and Develop a Scoring System to Predict Cytomegalovirus Gastrointestinal Disease?

Background/Aims: Early diagnosis of cytomegalovirus gastrointestinal disease (CMV-GID) is often deemed critical for the appropriate management of the disease. Although histopathological examination is the gold standard for diagnosis, non-invasive and early diagnostic methods may be needed to predict CMV-GID. As a rapid and non-invasive method, the detection of CMV DNA in plasma by polymerase chain reaction (PCR) can be utilized. In this study, the aim was to determine the optimal plasma CMV DNA cut-off value and to develop a scoring system as an adjunct diagnostic method for predicting CMV-GID. Materials and Methods: In this methodological study, the records of patients who underwent gastrointestinal biopsy and plasma CMV PCR testing were retrospectively reviewed. A scoring system based on multivariate analysis was established as a predictive model for CMV-GID. Receiver operating characteristic analysis was performed to determine the optimal plasma CMV DNA cut-off using the Youden Index and to evaluate the performance measures related to the proposed methods for predicting CMV-GID. Results: A total of 302 patients (125 with the diagnosis of CMV-GID and 177 without CMV-GID, based on their endoscopic biopsy reports and plasma CMV PCR results) were included. The optimal CMV DNA cut-off value in plasma to predict CMV-GID was determined to be 272 copies/mL. A total score of 28.1 obtained from the predictive model was set to be the optimal value for predicting CMV-GID. Conclusion: The use of a scoring system and an optimal CMV DNA cut-off may help to predict CMV-GID and facilitate early diagnosis and treatment.