Abstract
Background. Pancreas-kidney transplant recipients are at high risk for cytomegalovirus (CMV) disease despite prophylactic ganciclovir therapy. Because the impact of antiviral therapy on anti-CMV immune reactions is unknown, CMV-specific T-cell subsets in primary and recurrent CMV infection were analyzed in a pancreas-kidney transplant case study. Methods. Major histocompatibility complex class I tetramers were used to detect peripheral CMV pp65- specific CD8+ T cells. Intracellular cytokine staining was used to determine the frequency of CMV-specific CD4+ T cells. Conventional virologic parameters and routine laboratory parameters were monitored. For ganciclovir resistance testing, CMV-UL97 genotyping was performed. Results. Despite prophylactic ganciclovir therapy, primary CMV infection induced in vivo expansion of activated CMV-specific CD8+ T cells. Interestingly, viral dissemination during recurrent CMV disease was a result of partially ganciclovir-resistant CMV. Recovery after discontinued ganciclovir treatment was associated with the expansion of CMV-specific CD4+ T cells. Conclusion. Immunologic monitoring may contribute to clinical management of recurrent CMV disease.
Original language | English |
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Pages (from-to) | 724-727 |
Number of pages | 4 |
Journal | Transplantation |
Volume | 75 |
Issue number | 5 |
DOIs | |
State | Published - 15 Mar 2003 |