Analysis of spontaneous resolution of cytomegalovirus replication after transplantation in CMV-seropositive patients with pretransplant CD8+IFNG + response

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Arquivos
art_PAEZ-VEGA_Analysis_of_spontaneous_resolution_of_cytomegalovirus_replication_after_2018.PDF (1.48 MB)
Citações na Scopus
14
Tipo de produção
article
Data de publicação
2018
Editora
ELSEVIER SCIENCE BV
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
PAEZ-VEGA, Aurora
POYATO, Antonio
RODRIGUEZ-BENOT, Alberto
GUIRADO, Lluis
FORTUN, Jesus
LEN, Oscar
FARINAS, Maria C.
CORDERO, Elisa
GRACIA, Carmen de
Autor de Grupo de pesquisa
Spanish Network Res Infectious Dis
Spanish Renal Dis Network
Editores
Coordenadores
Organizadores
Citação
ANTIVIRAL RESEARCH, v.155, p.97-105, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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 +1FNG + 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 COB + 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.
Palavras-chave
Solid organ transplantation, Cytomegalovirus infection, T-cell response, QuantiFERON-CMV assay, Interferon-gamma
URI
https://observatorio.fm.usp.br/handle/OPI/28131
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - LIM/47