کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5668580 | 1592415 | 2017 | 10 صفحه PDF | دانلود رایگان |

- The CMV-specific T-cell response constitutes the main defense against CMV infection.
- A subgroup of transplant patients with no T-cell response is at more risk for CMV infection.
- Acquisition of CMV-specific cellular immunity reduced the risk of requiring early treatment and developing high-level viremia in transplant recipients at low risk for CMV infection.
- Using CMV serology for stratifying the risk of CMV after transplantation might be insufficient.
SummaryObjectivesTo characterize whether the CMV-specific cellular immune response can be used as a predictor of the control of CMV infection and disease and determine thresholds in solid organ transplant (SOT) recipients seropositive for CMV (R+).MethodsThe CMV-specific T-cell response was characterized using intracellular cytokine staining and the evolution of clinical and virological parameters were recorded during the first year after transplantation.ResultsBesides having positive CMV serology, only 28.4% patients had positive immunity (CD8+CD69+IFN-γ+ â¥0.25%) at 2 weeks after transplantation. These patients had less indication of preemptive treatment (p = 0.025) and developed less high grade (â¥2000 IU/ml) CMV replication episodes (p = 0.006) than patients with no immunity. Of the 49 patients with a pretransplant sample, only 22.4% had positive immunity, and had a detectable immune response early after transplantation (median of 3.7 weeks). However, only 50% of patients with negative pretransplant immunity acquired a positive immune response and it was significantly later, at a median of 11 weeks (p < 0.001). Patients that developed CMV disease had no CMV-specific immunity.ConclusionsHaving CMV-specific CD8+IFN-γ+ cells â¥0.25% before transplant; 0.15% at two weeks or 0.25% at four weeks after transplantation, identifies patients that may spontaneously control CMV infection and may require less monitoring.
Journal: Journal of Infection - Volume 75, Issue 4, October 2017, Pages 336-345