Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 195, Issue 5, Pages 633-644Publisher
UNIV CHICAGO PRESS
DOI: 10.1086/511307
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Funding
- NCI NIH HHS [P01-CA30206, CA33572, R01-CA77544] Funding Source: Medline
- NCRR NIH HHS [MO1-RR0043-38] Funding Source: Medline
- NIAID NIH HHS [AI52065] Funding Source: Medline
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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)-gamma-producing CD4(+) and IFN-gamma-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.
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