Analysis of spontaneous resolution of cytomegalovirus replication after transplantation in CMV-seropositive patients with pretransplant CD8+IFNG+ response
Copyright © 2018 Elsevier B.V. All rights reserved..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:155 |
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| Enthalten in: |
Antiviral research - 155(2018) vom: 01. Juli, Seite 97-105 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Páez-Vega, Aurora [VerfasserIn] |
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| Links: |
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| Themen: |
82115-62-6 |
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| Anmerkungen: |
Date Completed 01.08.2019 Date Revised 04.12.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.antiviral.2018.05.006 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM284289825 |
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| 100 | 1 | |a Páez-Vega, Aurora |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Analysis of spontaneous resolution of cytomegalovirus replication after transplantation in CMV-seropositive patients with pretransplant CD8+IFNG+ response |
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| 500 | |a Date Revised 04.12.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018 Elsevier B.V. All rights reserved. | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Cytomegalovirus infection | |
| 650 | 4 | |a Interferon-gamma | |
| 650 | 4 | |a QuantiFERON-CMV assay | |
| 650 | 4 | |a Solid organ transplantation | |
| 650 | 4 | |a T-cell response | |
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| 700 | 1 | |a Rodriguez-Benot, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Guirado, Lluis |e verfasserin |4 aut | |
| 700 | 1 | |a Fortún, Jesús |e verfasserin |4 aut | |
| 700 | 1 | |a Len, Oscar |e verfasserin |4 aut | |
| 700 | 1 | |a Abdala, Edson |e verfasserin |4 aut | |
| 700 | 1 | |a Fariñas, María C |e verfasserin |4 aut | |
| 700 | 1 | |a Cordero, Elisa |e verfasserin |4 aut | |
| 700 | 1 | |a de Gracia, Carmen |e verfasserin |4 aut | |
| 700 | 1 | |a Hernández, Domingo |e verfasserin |4 aut | |
| 700 | 1 | |a González, Rafael |e verfasserin |4 aut | |
| 700 | 1 | |a Torre-Cisneros, Julián |e verfasserin |4 aut | |
| 700 | 1 | |a Cantisán, Sara |e verfasserin |4 aut | |
| 700 | 0 | |a Spanish Network for Research in Infectious Diseases (REIPI) (RD16/0016) |e verfasserin |4 aut | |
| 700 | 0 | |a Spanish Renal Disease Network (REDinREN, RD16/0009) |e verfasserin |4 aut | |
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| 700 | 1 | |a Rodriguez-Benot, Alberto |e investigator |4 oth | |
| 700 | 1 | |a Fortún, Jesús |e investigator |4 oth | |
| 700 | 1 | |a Len, Oscar |e investigator |4 oth | |
| 700 | 1 | |a Fariñas, María C |e investigator |4 oth | |
| 700 | 1 | |a Cordero, Elisa |e investigator |4 oth | |
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| 700 | 1 | |a Rodriguez-Benot, Alberto |e investigator |4 oth | |
| 700 | 1 | |a Guirado, Lluis |e investigator |4 oth | |
| 700 | 1 | |a Hernández, Domingo |e investigator |4 oth | |
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