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Infection with cytomegalovirus (CMV), a ubiquitous herpesvirus, is the most common life-threatening opportunistic infection in patients with AIDS or with transplants involving solid organs, stem cells and bone marrow.1-12 After the neonatal period, primary infection with human CMV in healthy, immuno-competent individuals is typically benign and the virus then remains latent in the host. In severely immunocompromised individuals, however, primary infection or reactivation of latent virus can result in a variety of syndromes including retinitis, colitis, pneumonia and encephalitis. CMV viremia is a reliable predictor of disease development and an indicator of treatment failure. CMV DNA quantitation is useful for determining when infection becomes active and guiding decisions about pre-emptive therapy and/or prophylaxis. The presence of CMV DNA in plasma of advanced AIDS patients increases risk of developing CMV disease 3-fold and increases the risk of death more than 2-fold. For each log10 increase in viral load (above baseline), risk of developing CMV disease increases 3-fold and risk of death increases 2-fold.13 Because drug treatment for CMV averages over $26,000 per patient per year,12 early detection of drug failure using the CMV DNA UltraQuant ® is a cost-effective resource for therapeutic management. Specialty also offers the CMV DNA UltraRapid ™ with a 24 hour turnaround time on CSF specimens, for evaluating CMV encephalitis. Clinical Utility • Ultrasensitive monitoring of CMV viral load by PCR • More sensitive than Hybrid Capture method • Negative predictive value of 100%; lack of CMV DNA in plasma is an excellent indication that disease is not likely to develop, even when CMV is detected in the blood by culture14 • In patients receiving antiviral therapy, detection of increases in CMV viral load is associated with emergence of virus variants with reduced susceptibility to ganciclovir, foscarnet and/or cidofovi