Analysis of spontaneous resolution of cytomegalovirus replication after transplantation in CMV-seropositive patients with pretransplant CD8+IFNG+ response.

Autor: Páez-Vega A; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain(1)., Poyato A; Department of Hepatology, Reina Sofia Hospital, Cordoba, Spain., Rodriguez-Benot A; Department of Nephrology, Reina Sofia Hospital, Cordoba, Spain(2)., Guirado L; Puigvert Fundació, Barcelona, Spain(3)., Fortún J; Infectious Diseases Unit, Ramón y Cajal Hospital. Madrid, Spain(4)., Len O; Infectious Diseases Unit Vall d'Hebron Hospital, Barcelona, Spain(5)., Abdala E; Departamento de Molestias infecciosas e Parasitarias da Faculdade de Medicina da Universidade de Sao Paulo, Brazil., Fariñas MC; Infectious Diseases Unit, Marqués de Valdecilla Hospital, University of Cantabria, IDIVAL, Santander, Spain(6)., Cordero E; Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocío University Hospital/ CSIC/University of Seville, Unit of Infectious Disease, Microbiology and Preventive Medicine, Seville, Spain(7)., de Gracia C; Department of Nephrology, Virgen de las Nieves Hospital, Granada, Spain., Hernández D; Department of Nephrology, Carlos Haya Regional University Hospital and University of Malaga, IBIMA, RedInRen (RD16/0009/0006), Malaga, Spain(8)., González R; Department of Immunology, Reina Sofia Hospital, Cordoba, Spain., Torre-Cisneros J; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain(1); Infectious Diseases Unit, Reina Sofía Hospital, Cordoba, Spain(9). Electronic address: julian.torre.sspa@juntadeandalucia.es., Cantisán S; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain(1).
Jazyk: angličtina
Zdroj: Antiviral research [Antiviral Res] 2018 Jul; Vol. 155, pp. 97-105. Date of Electronic Publication: 2018 May 18.
DOI: 10.1016/j.antiviral.2018.05.006
Abstrakt: This prospective study evaluates whether CMV-seropositive (R+) transplant patients with pretransplant CD8+IFNG+ T-cell response to cytomegalovirus (CMV) (CD8+IFNG+ response) can spontaneously clear the CMV viral load without requiring treatment. A total of 104 transplant patients (kidney/liver) with pretransplant CD8+IFNG+ response were evaluable. This response was determined using QuantiFERON-CMV assay. The incidence of CMV replication and disease was 45.2% (47/104) and 6.7% (7/104), respectively. Of the total patients, 77.9% (81/104) did not require antiviral treatment, either because they did not have CMV replication (n = 57) or because they had asymptomatic CMV replication that could be spontaneously cleared (n = 24). Both situations are likely related to the presence of CD8+IFNG+ response to CMV, which has a key role in controlling CMV infection. However, 22.1% of the patients (23/104) received antiviral treatment, although only 7 of them did so because they had symptomatic CMV replication. These patients developed symptoms in spite of having pretransplant CD8+IFNG+ response, thus suggesting that other immunological parameters might be involved, such as a dysfunctional CD4 + response or that they might have become QFNon-reactive due to the immunosuppression. In conclusion, around 80% of R+ patients with pretransplant CD8+IFNG+ response to CMV did not require antiviral treatment, although this percentage might be underestimated. Nevertheless, other strategies such as performing an additional CD8+IFNG+ response determination at posttransplant time might provide more reliable information regarding the patients who will be able to spontaneously clear the viremia.
(Copyright © 2018 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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