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- Title
Longitudinal Assessment of Cytomegalovirus (CMV)--Specific Immune Responses in Liver Transplant Recipients at High Risk for Late CMV Disease.
- Authors
La Rosa, Corinna; Limaye, Ajit P.; Krishnan, Aparna; Longmate, Jeff; Diamond, Don J.
- Abstract
Cytomegalovirus (CMV)-seronegative recipients (R-) of a liver transplant from CMV-positive donors (D+) are at high risk for developing late CMV disease after discontinuation of antiviral prophylaxis. Levels of viremia and CMV-specific interferon (IFN)-γ-producing CD4+ and IFN-γ-producing CD8+ T cell responses were prospectively measured from discontinuation of antiviral prophylaxis until 1 year after transplantation in 17 consecutive D+/R- patients. CMV loads of >1000 copies/mL were strongly associated with CMV disease in the 6 symptomatic patients. Despite immunosuppression, broadly diverse T cells specific for CMV lysate or peptide libraries spanning pp65 and immediate early (IE) 1 immunodominant CMV antigens developed in all patients. A vigorous CD8+ T cell response to pp65 and IE1 antigens characterized the D+/R- cohort. Unexpectedly, none of these responses were predictive of CMV disease or viremia. No significant lymphopenia or functional impairment of CMV-specific T cells was detected in the symptomatic patients, whose morbidity was resolved after antiviral treatment while measurable CMV immunity was maintained during the 1-year observation period.
- Subjects
CYTOMEGALOVIRUSES; TRANSPLANTATION of organs, tissues, etc.; LIVER transplantation; IMMUNE response; T cells; IMMUNOSUPPRESSION
- Publication
Journal of Infectious Diseases, 2007, Vol 195, Issue 5, p633
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1086/511307