Viral escape and T-cell immunity during ganciclovir treatment of cytomegalovirus infection: Case report of a pancreatico-renal transplant recipient

Christine Benz, Gisela Holz, Detlef Michel, Sabine Awerkiew, Volker Dries, Dirk Stippel, Tobias Goeser, Dirk H. Busch

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

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 languageEnglish
Pages (from-to)724-727
Number of pages4
JournalTransplantation
Volume75
Issue number5
DOIs
StatePublished - 15 Mar 2003

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