Cytomegalovirus (CMV)-specific CD4+ T lymphocyte immune function in long-term survivors of AIDS-related CMV end-organ disease who are receiving potent antiretroviral therapy.
To better understand the relation of cytomegalovirus (CMV)-specific CD4+ T lymphocyte immunity and clinical outcome in AIDS-related CMV end-organ disease, 2 patient groups were prospectively studied: patients recently diagnosed with active CMV end-organ disease and survivors of CMV retinitis who had responded to highly active antiretroviral therapy and had quiescent retinitis when anti-CMV therapy was discontinued. Most patients with active CMV disease had negative CMV-specific CD4+ T lymphocyte responses at diagnosis, as measured by lymphoproliferation (7/7) or cytokine flow cytometry (3/5) assays. In contrast, all 10 subjects with quiescent retinitis and >150 absolute CD4+ T lymphocytes/microL whose anti-CMV therapy was discontinued during 6 months of follow-up had positive CMV-specific immune responses at least once by each assay. However, 6 of these 10 subjects also had negative CMV-specific immune responses > or =1 time. Such patients may be at risk for future CMV disease progression and should be closely monitored.
Jacobson
M A
MA
University of California San Francisco, Department of Medicine, Ward 84, 995 Potrero St., San Francisco, CA 94110, USA. mjacobson@php.ucsf.edu
Schrier
R
R
McCune
J M
JM
Torriani
F J
FJ
Holland
G N
GN
O'Donnell
J J
JJ
Freeman
W R
WR
Bredt
B M
BM
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D016207:Cytokines; D003587:Cytomegalovirus / Q000187:drug effects / Q000276:immunology*; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy / Q000276:immunology*; D018450:Disease Progression; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017741:Survivors; D016896:Treatment Outcome
D016207:Cytokines