先天性ろ紙上リアルタイムPCR法：ＣＭＶ感染症に対するスクリーニングは感度悪すぎて、不適

ろ紙上でのリアルタイムPCR法は、”陽性者の割合が低い疾患又は感染においても容易に低コストで実施可能な簡便、迅速、高感度なスクリーニング方法”らしい（参照）


しかしながら、ＰＣＲ法は、感度が低く、約２／３の先天性ＣＭＶ感染を見逃すことがわかった

Dried Blood Spot Real-time Polymerase Chain Reaction Assays to Screen Newborns for Congenital Cytomegalovirus Infection
the National Institute on Deafness and Other Communication Disorders CMV and Hearing Multicenter Screening (CHIMES) Study
JAMA. 2010;303(14):1375-1382.

・single-primer DBS PCR identified congenital CMV infection
sensitivity 　28.3% (95% CI, 17.4%-41.4%)
specificit　99.9% (95% CI, 99.9%-100%)
positive LR 　803.7 (95% CI, 278.7-2317.9)
negative LR 　0.7 (95% CI, 0.6-0.8)
positive predictive value 80.9% (95% CI, 58.1%-94.5%)
negative predictive value 99.6% (95% CI, 99.5%-99.7%)

・The 2-primer DBS PCR assay identified infants with congenital CMV infection with sensitivity　34.4% (95% CI, 18.6%-53.2%)
specificity　99.9% (95% CI, 99.9%-100.0%)
positive LR 　3088.9 (95% CI, 410.8-23 226.7)
negative LR　0.7 (95% CI, 0.5-0.8)
positive predictive value 91.7% (95% CI, 61.5%-99.8%)
negative predictive value 99.8% (95% CI, 99.6%-99.9%)