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Department of Allergy, Immunology, and Respiratory Medicine, Alfred Hospital, Melbourne, Australia
We thank Meylan and Zanetti [1] for their positive review of our article [2] and are encouraged to see that our results concur with their own experiences. We also welcome the opportunity to provide additional clarification of our published data and, in particular, to expand on how we arrived at a threshold virus load of 46,000 copies/mL in bronchoalveolar lavage (BAL) samples for predicting histological human cytomegalovirus (HCMV) infection.
There are now a number of studies that have examined the utility of molecular detection tests for HCMV DNA in both blood and BAL samples, and it is increasingly being recognized that quantitative molecular diagnostic assays for HCMV DNA is the preferred diagnostic tool. With the wider use of these assays, it needs to be appreciated that results and threshold values are likely to differ between laboratories that are using different sampling methods and amplification protocols. Therefore, the aim for the future needs to be toward improved standardization of this important diagnostic tool.
References
1. Meylan PRA, Zanetti G. Human cytomegalovirus load in plasma and bronchoalveolar lavage fluid: a longitudinal study of lung transplant recipients . J Infect Dis 2005; 191:2153 (in this issue). First citation in article
2. Westall GP, Michaelides A, Williams TJ, Snell GI, Kotsimbos TC. Human cytomegalovirus load in plasma and bronchoalveolar lavage fluid: a longitudinal study of lung transplant recipients. J Infect Dis 2004; 190:107683. First citation in article
3. Riise GC, Andersson R, Bergstrom T, Lundmark A, Nilsson FN, Olofson S. Quantification of cytomegalovirus DNA in BAL fluid: a longitudinal study in lung transplant recipients. Chest 2000; 118:165360. First citation in article