Preformed Frequencies of Cytomegalovirus (CMV)―Specific Memory T and B Cells Identify Protected CMV-Sensitized Individuals Among Seronegative Kidney Transplant Recipients
In: Clinical infectious diseases, Jg. 59 (2014), Heft 11, S. 1537-1545
Online
academicJournal
- print, 28 ref
Zugriff:
Background. Cytomegalovirus (CMV) infection remains a major complication after kidney transplantation. Baseline CMV risk is typically determined by the serological presence of preformed CMV-specific immunoglobulin (Ig) G antibodies, even though T-cell responses to major viral antigens are crucial when controlling viral replication. Some IgG-seronegative patients who receive an IgG-seropositive allograft do not develop CMV infection despite not receiving prophylaxis. We hypothesized that a more precise evaluation of pretransplant CMV-specific immune-sensitization using the B and T-cell enzyme-linked immunospot assays may identify CMV-sensitized individuals more accurately, regardless of serological evidence of CMV-specific IgG titers. Methods. We compared the presence of preformed CMV-specific memory B and T cells in kidney transplant recipients between 43 CMV IgG-seronegative (sR―) and 86 CMV IgG-seropositive (sR+) patients. Clinical outcome was evaluated in both groups. Results. All sR+ patients showed a wide range of CMV-specific memory T- and B-cell responses. High memory T- and B-cell frequencies were also clearly detected in 30% of sR― patients, and those with high CMV-specific T-cell frequencies had a significantly lower incidence of late CMV infection after prophylactic therapy. Receiver operating characteristic curve analysis for predicting CMV viremia and disease showed a high area under the receiver operating characteristic curve (>0.8), which translated into a high sensitivity and negative predictive value of the test. Conclusions. Assessment of CMV-specific memory T- and B-cell responses before kidney transplantation among sR― recipients may help identify immunized individuals more precisely, being ultimately at lower risk for CMV infection.
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Preformed Frequencies of Cytomegalovirus (CMV)―Specific Memory T and B Cells Identify Protected CMV-Sensitized Individuals Among Seronegative Kidney Transplant Recipients
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Autor/in / Beteiligte Person: | LUCIA, Marc ; CRESPO, Elena ; BESTARD, Oriol ; MELILLI, Edoardo ; CRUZADO, Josep M ; LUQUE, Sergi ; LLAUDO, Inés ; NIUBO, Jordi ; TORRAS, Joan ; FERNANDEZ, Núria ; GRINYO, Josep M |
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Zeitschrift: | Clinical infectious diseases, Jg. 59 (2014), Heft 11, S. 1537-1545 |
Veröffentlichung: | Oxford: Oxford University Press, 2014 |
Medientyp: | academicJournal |
Umfang: | print, 28 ref |
ISSN: | 1058-4838 (print) |
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