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J Infect Dis. 2017 Jun 1;215(11):1684-1694. doi: 10.1093/infdis/jix192.

Identifying Cytomegalovirus Complications Using the Quantiferon-CMV Assay After Allogeneic Hematopoietic Stem Cell Transplantation.

Author information

1
Department of Infectious Diseases, Monash University and Alfred Hospital.
2
Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital.
3
Victorian Infectious Diseases Service, Royal Melbourne Hospital at The Peter Doherty Institute for Infection and Immunity.
4
Peter MacCallum Cancer Centre.
5
Department of Haematology, Monash University and Alfred Hospital.
6
Department of Clinical Haematology and Bone Marrow Transplant Service, Royal Melbourne Hospital.
7
Department of Medicine, University of Melbourne, Melbourne, Australia.
8
Institut National de la Sante et de la Recherche Medicale, U1135, Centre d'Immunologie et des Maladies Infectieuses, Sorbonne Universités, University Pierre et Marie Curie.
9
Assistance Publique-Hopitaux de Paris, Hôpital Pitié-Salpêtrière, Département d'Immunologie, France.

Abstract

Background:

A simple test to identify recovery of CMV-specific T-cell immunity following hematopoietic stem cell transplantation (HSCT) could assist clinicians in managing CMV-related complications.

Methods:

In an observational, multicenter, prospective study of 94 HSCT recipients we evaluated CMV-specific T-cell immunity at baseline, 3, 6, 9, and 12 months after transplant using the Quantiferon-CMV, an enzyme-linked immunosorbent spot assay (ELISpot), and intracellular cytokine staining.

Results:

At 3 months after HSCT, participants who developed CMV disease (n = 8) compared with CMV reactivation (n = 26) or spontaneous viral control (n = 25) had significantly lower CD8+ T-cell production of interferon-γ (IFN-γ) in response to CMV antigens measured by Quantiferon-CMV (P = .0008). An indeterminate Quantiferon-CMV result had a positive predictive value of 83% and a negative predictive value of 98% for identifying participants at risk of further CMV reactivation. Participants experiencing CMV reactivation compared with patients without CMV reactivation had a reduced proportion of polyfunctional (IFN-γ+/tumor necrosis factor α-positive) CD4+ and CD8+ T cells and a higher proportion of interleukin 2-secreting cells (P = .01 and P = .002, respectively).

Conclusions:

Quantifying CMV-specific T-cell immunity after HSCT can identify participants at increased risk of clinically relevant CMV-related outcomes.

KEYWORDS:

T-cell immunity; cytomegalovirus; immunocompromised host; stem cell transplantation; viral immunity

PMID:
28431019
DOI:
10.1093/infdis/jix192
[Indexed for MEDLINE]

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