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J Clin Virol. 2014 Dec;61(4):523-8. doi: 10.1016/j.jcv.2014.09.015. Epub 2014 Oct 5.

Evaluation of CMV-specific cellular immune response by EliSPOT assay in kidney transplant patients.

Author information

1
Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy. Electronic address: ccosta2@cittadellasalute.to.it.
2
Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
3
Renal Transplant Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.

Abstract

BACKGROUND:

Immunological monitoring for CMV can be useful in transplant patients; however, few centers perform it on a routine basis.

OBJECTIVES:

In this study, CMV-specific cellular response was evaluated in a population of kidney transplant recipients and related to viral infection/reactivation and other demographic and clinical features.

STUDY DESIGN:

Three hundred and twenty-eight patients were studied by EliSPOT assay: 201 prospectively monitored in the first year posttransplantation, 127 with a single determination at >1 year. Clinical features, including occurrence of CMV-DNAemia, CMV serostatus, anti-viral strategies and immunosuppressive protocols, were evaluated.

RESULTS:

Overall, 66.5% of patients were CMV-responders at EliSPOT assay. No episode of infection occurred at follow-up (mean 24.5 months) in 73.4% responders versus 55.5% non-responders (p<0.005); CMV-free period was significantly longer in responders (p<0.001). Although no significant difference of peak viral load was found, prevalence of CMV-DNAemia values >10(5)copies/mL was significantly higher in non-responders versus responders (8.2% and 2.3%, p<0.05). Non-responder status was significantly associated to CMV-seronegativity (p<0.0001), anti-viral prophylaxis use (p<0.0001), and immunosuppression induction with basiliximab (p<0.005). No significant association was found for other clinical features and immunosuppressive protocols.

CONCLUSIONS:

Immunological data for CMV could be used in the clinical evaluation and decision-making process, in combination with virological monitoring, in kidney transplant recipients.

KEYWORDS:

CMV-DNAemia; Cellular immune response; Cytomegalovirus; EliSPOT assay; Kidney transplantation

PMID:
25453571
DOI:
10.1016/j.jcv.2014.09.015
[Indexed for MEDLINE]
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