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HelpTest ID CMVNG Cytomegalovirus (CMV) Drug Resistance, Next-Generation Sequencing, Plasma
Ordering Guidance
This test is not intended for the initial diagnosis of cytomegalovirus (CMV) infection. If a diagnostic test is needed, order CMVQN / Cytomegalovirus (CMV) DNA Detection and Quantification by Real-Time PCR, Plasma.
Next-generation sequencing testing may be indicated if a patient with known CMV infection has a rising, or stabilizing, viral load while on antiviral therapy. This test can assist in determining whether CMV is present that has acquired mutations (variants) associated with antiviral resistance and should only be performed on patients who have had a recent (ie, within the previous 7 days) CMV quantitative plasma viral load of 500 IU/mL or greater.
Testing for CMV resistance should be performed no more frequently than once every 4 weeks.
Changes in CMV viral load 0.5 log or greater are considered significant and may prompt testing for antiviral resistance if the patient is on appropriate therapy.
Additional Testing Requirements
Plasma submitted for next-generation sequencing (NGS) testing must have been collected within 7 days of a viral load assay (CMVQN / Cytomegalovirus [CMV] DNA Detection and Quantification by Real-Time PCR, Plasma or similar test) with a result of 500 IU/mL or greater.
Shipping Instructions
1. Freeze plasma specimen immediately, and ship specimen frozen on dry ice.
2. If shipment will be delayed for more than 14 days, freeze plasma specimen at -20 to -80° C (up to 30 days) until shipment on dry ice.
Specimen Required
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 1.2 mL
Collection Instructions: Centrifuge and aliquot plasma into a plastic vial.
Additional Information: Plasma for next-generation sequencing must be collected within 7 days of a viral load assay (ie, CMVQN) with a result of 500 IU/mL or greater.
Useful For
Detecting mutations (variants) in the cytomegalovirus genes, UL97 and UL54, which are associated with antiviral resistance
This test is not useful for the initial diagnosis of CMV infection
Testing Algorithm
This test may be performed following quantitative nucleic acid amplification test results that suggest an increase, or stabilization, of cytomegalovirus viral load while the patient is on appropriate antiviral therapy.
Method Name
Next-Generation Sequencing (NGS)
Reporting Name
CMV Antiviral Resistance by NGS, PSpecimen Type
Plasma EDTASpecimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma EDTA | Frozen (preferred) | 30 days | |
| Refrigerated | 14 days |
Reference Values
None Detected/Not Predicted
Day(s) Performed
Monday
Report Available
16 to 20 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
87910
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CMVNG | CMV Antiviral Resistance by NGS, P | 72852-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 604560 | CMV UL97 mutations | 72833-7 |
| 604561 | CMV UL54 mutations | 33631-3 |
| 604562 | Ganciclovir Resistance | 72854-3 |
| 604563 | Cidofovir Resistance | 72856-8 |
| 604564 | Foscarnet Resistance | 42317-8 |
| CMVQ1 | CMV Quant >= 500 IU/mL last 7 days? | 86955-2 |
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.