Ex vivo monitoring of human cytomegalovirus-specific CD8+ T-Cell responses using the QuantiFERON®-CMV assay in allogeneic hematopoietic stem cell transplant recipients attending an Irish hospital
✍ Scribed by T. Fleming; J. Dunne; B. Crowley
- Publisher
- John Wiley and Sons
- Year
- 2010
- Tongue
- English
- Weight
- 97 KB
- Volume
- 82
- Category
- Article
- ISSN
- 0146-6615
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✦ Synopsis
Abstract
Reconstitution of human cytomegalovirus (HCMV) T‐cell immunity is crucial in hematopoietic stem cell transplant (HSCT) recipients. The QuantiFERON®‐CMV assay for cellular HCMV‐specific immunity was evaluated in allogeneic HSCT recipients (n = 43) and patients with hematological malignancies (n = 29) attending a tertiary‐care Irish hospital. An intracellular cytokine (ICC) assay correlated with the QuantiFERON®‐CMV assay. Although there was agreement between HCMV seropositivity and QuantiFERON®‐CMV assay, six HCMV seropositive immunosuppressed patients with hematological malignancy had negative QuantiFERON®‐CMV results. The 43 HSCT recipients were classified as high risk (D^−^/R^+^) (n = 18), intermediate risk (D^+^/R^+^ and D^+^/R^−^) (n = 17), and low risk (D^−^/R^−^) (n = 8). During episodes of HCMV DNAemia no evidence of HCMV‐specific immunity was found using the QuantiFERON®‐CMV assay. Furthermore, the recovery of HCMV‐specific CD8^+^ T‐cell responses in high‐risk seropositive recipients of matched unrelated donors was severely delayed, a mean of 200 (SD = 117) days compared to 58 (SD = 23) days for sibling donors (P ≤ 0.028). In addition, three patients with late HCMV infection (infection >100 days post‐transplant) had delayed reconstitution of HCMV‐specific CD8^+^ T cells. Interestingly, two recipients (R^+^/D^−^) developed rapid immune reconstitution by days 15 and 36 post‐HSCT, suggesting HCMV‐specific T‐cell lymphopoiesis of recipient origin. Levels of CD8^+^ T‐cell immunity in HCMV seropositive HSCT recipients were lowest following HSCT. A high number (33%) of indeterminate results was observed immediately after transplantation. Patients with indeterminate QuantiFERON®‐CMV results had low levels of HCMV‐specific CD8^+^ T cells. J. Med. Virol. 82:433–440, 2010. © 2010 Wiley‐Liss, Inc.