Viral escape and T-cell immunity during ganciclovir treatment of cytomegalovirus infection: case report of a pancreatico-renal transplant recipient1
作者:
Christine Benz,
Gisela Holz,
Detlef Michel,
Sabine Awerkiew,
Volker Dries,
Dirk Stippel,
Tobias Goeser,
Dirk Busch,
期刊:
Transplantation
(OVID Available online 2003)
卷期:
Volume 75,
issue 5
页码: 724-727
ISSN:0041-1337
年代: 2003
出版商: OVID
数据来源: OVID
摘要:
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.
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