title: Comparative analysis of human cytomegalovirus-specific CD4(+) T-cell frequency and lymphoproliferative response in human immunodeficiency virus-positive patients.
abstract: Evaluation of human cytomegalovirus (HCMV)-specific T-helper immunity could contribute in optimizing anti-HCMV therapy in human immunodeficiency virus (HIV)-infected patients. Testin the lymphoproliferative response (LPR) is the standard technique used to evaluate T-helper response, but its use in the routine diagnostic laboratory setting can be problematic. The most promising new alternative technique is the determination of HCMV-specific CD4(+) T-cell frequency by flow cytometry detection of intracellular cytokine production after short-term antigen-specific activation of peripheral blood mononuclear cells. HCMV-specific LPR and CD4(+) T-cell frequency were compared in a group of 78 blood samples from 65 HIV-infected patients. The results showed concordance in 80.7% of samples. In addition, comparative analysis of sequential blood samples from 13 HIV-infected patients showed that while in about half of patients the T-helper HCMV-specific immune response remained stable during highly active antiretroviral therapy (HAART), in the other half declining levels of the HCMV-specific CD4(+)-mediated immune response were determined by either one or both assays. In conclusion, our data suggest that the determination of HCMV-specific CD4(+) T-cell frequency can be considered a valuable alternative to the LPR test for the detection of HCMV-specific T-helper response in HIV-infected patients. It could facilitate wider screening of anti-HCMV T-helper activity in HIV-infected patients, with potential benefits for clinicians in deciding strategies of discontinuation or maintenance of anti-HCMV therapy.
authors.affiliation: Servizio di Virologia, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Piccinini
authors.forename: G
authors.initials: G
authors.lastname: Comolli
authors.forename: E
authors.initials: E
authors.lastname: Genini
authors.forename: D
authors.initials: D
authors.lastname: Lilleri
authors.forename: R
authors.initials: R
authors.lastname: Gulminetti
authors.forename: R
authors.initials: R
authors.lastname: Maccario
authors.forename: M G
authors.initials: MG
authors.lastname: Revello
authors.forename: G
authors.initials: G
authors.lastname: Gerna
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology* / Q000821:virology; D002455:Cell Division / Q000276:immunology; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D015203:Reproducibility of Results