RT Journal Article
T1 Analysis of spontaneous resolution of cytomegalovirus replication after transplantation in CMV-seropositive patients with pretransplant CD8+IFNG+ response.
A1 Paez-Vega, Aurora
A1 Poyato, Antonio
A1 Rodriguez-Benot, Alberto
A1 Guirado, Lluis
A1 Fortun, Jesus
A1 Len, Oscar
A1 Abdala, Edson
A1 Fariñas, Maria C
A1 Cordero, Elisa
A1 de-Gracia, Carmen
A1 Hernandez, Domingo
A1 Gonzalez, Rafael
A1 Torre-Cisneros, Julian
A1 Cantisan, Sara
K1 Cytomegalovirus infection
K1 Interferon-gamma
K1 QuantiFERON-CMV assay
K1 Solid organ transplantation
K1 T-cell response
AB 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.
PB Elsevier
YR 2018
FD 2018-05-11
LK http://hdl.handle.net/10668/12491
UL http://hdl.handle.net/10668/12491
LA en
NO Páez-Vega A, Poyato A, Rodriguez-Benot A, Guirado L, Fortún J, Len O, et al.  Analysis of spontaneous resolution of cytomegalovirus replication after transplantation in CMV-seropositive patients with pretransplant CD8+IFNG+ response. Antiviral Res. 2018 Jul;155:97-105
NO We are grateful to the patients who volunteered to provide blood specimens and we thank the staff at the liver and kidney transplant units from the centers for obtaining the samples. We particularly thank Ana Salinas for invaluable technical support. We also acknowledge the statistical expertise of Llenalia García. This work was supported by Planes Nacionales de I+D+i 2008-2011/2013-2016 and Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Economía y Competitividad, Spanish Network for Research in Infectious Diseases (REIPI RD12/0015/0002 and REIPI RD16/0016/0008, D16/0016/0003, RD16/0016/0011, RD16/0016/0007), Spanish Renal Research Network (REDinREN, RD16/0009/0006, RD16/0009/0034 and RD16/0009/0019), co-financed by European Development Regional Fund “A way to achieve Europe” and operative program Intelligent Growth 2014-2020. It was also supported by the Consejería de Salud, Junta de Andalucía [grant number PI-0004-2012 to S.C.]. Other researchers participating in the study: Pilar Barrera, Marisa Agüera, Cristian Rodelo-Haad, Antonio Rivero-Juárez, Mario Frías
DS RISalud
RD Apr 5, 2025