Association of CMV-Specific T Cell-Mediated Immunity with CMV DNAemia and Development of CMV Disease in HIV-1-Infected Individuals

被引:5
作者
Aichelburg, Maximilian C. [1 ]
Weseslindtner, Lukas [2 ]
Mandorfer, Mattias [3 ]
Strassl, Robert [4 ]
Rieger, Armin [1 ]
Reiberger, Thomas [3 ]
Puchhammer-Stoeckl, Elisabeth [2 ]
Grabmeier-Pfistershammer, Katharina [1 ]
机构
[1] Med Univ Vienna, Div Immunol Allergy & Infect Dis DIAID, Dept Dermatol, Vienna, Austria
[2] Med Univ Vienna, Dept Virol, Vienna, Austria
[3] Med Univ Vienna, Dept Internal Med 3, Div Gastroenterol & Hepatol, HIV & Liver Study Grp, Vienna, Austria
[4] Med Univ Vienna, Div Clin Virol, Dept Lab Med, Vienna, Austria
关键词
ACTIVE ANTIRETROVIRAL THERAPY; HIV-INFECTED INDIVIDUALS; GAMMA RELEASE ASSAY; HUMAN CYTOMEGALOVIRUS; TRANSPLANT RECIPIENTS; NATURAL-HISTORY; ANTIVIRAL PROPHYLAXIS; ERA; RESPONSES; RISK;
D O I
10.1371/journal.pone.0137096
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Among HIV-1-infected individuals, cytomegalovirus (CMV) reactivation and disease occur in the setting of advanced immunosuppression. The value of a standardized assessment of CMV-specific T-cell mediated immunity by the CMV QuantiFERON assay (CMV-QFT) has not yet been thoroughly investigated in HIV-1-infected subjects. Methods Prospective, longitudinal study in 153 HIV-1-infected subjects with a CD4(+) T cell count < 350/mu L who simultaneously underwent CMV-QFT, CMV serology testing and CMV-DNA quantification. Factors associated with CMV-QFT were evaluated. Clinical screening for CMV manifestations was then performed every 3 months. Results Among the 141 CMV IgG-seropositive individuals the CMV-QFT assay yielded reactive results in 84% (118/141), negative results in 15% (21/141) and indeterminate (negative mitogen IFN-gamma response) results in 1% (2/141) of subjects. The mean actual CD4(+) T cell count was significantly higher in CMV-QFT reactive subjects, when compared to CMV-QFT non-reactive individuals (183 +/- 102 vs. 126 +/- 104 cells/mu L, P = 0.015). A significantly lower proportion of CMV-QFT reactive vs. non-reactive patients displayed CMV DNAemia > 100 copies/mL (23% (27/118) vs. 48% (11/23), P = 0.02). Furthermore, a statistically significant inverse association between mitogen IFN-gamma response and CMV-DNAemia > 1000 copies/mL was observed (P < 0.001). During the observational period, 5 CMV end-organ manifestations were observed. In three of the CMV cases the CMV-QFT yielded indeterminate results. Conclusions While CMV-QFT reactivity indicates CMV-specific immunity, indeterminate results due to negative mitogen IFN-gamma response might reflect HIV-1-induced immunodeficiency. Thus, dependency upon CD4(+) T cell count should be considered when interpreting CMV-QFT results.
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