Human cytomegalovirus (HCMV) replication dynamics in HCMV-naive and -experienced immunocompromised hosts.
Human cytomegalovirus (HCMV) can infect both HCMV-naive and -experienced transplant patients. In this study, the growth rate of HCMV in HCMV-naive hosts (1.82 units/day; 95% confidence interval [CI], 1.44-2.56 units/day) was shown to be significantly faster than the growth rate of virus in HCMV-experienced hosts undergoing recurrent infection (0.61 units/day; 95% CI, 0.55-0.7 units/day; P<.0001). The basic reproductive number (R(0)) for HCMV-naive liver transplant patients was 15.1 (95% CI, 8.9-44) but was only 2.4 (95% CI, 2.35-2.8) for HCMV-experienced transplant recipients, corresponding to an anti-HCMV immune efficacy of approximately 84%, despite immunosuppressive therapy. The R(0) values suggest that an anti-HCMV drug or vaccine with an efficacy of >93% (95% CI, 89%-98%) is required to eliminate viral growth during infection of HCMV-naive liver transplant recipients, whereas lower efficacy levels are sufficient to reduce the R(0) value to <1 in hosts with prior HCMV immunity.
Emery
Vincent C
VC
Royal Free and University College Medical School, Dept. of Virology, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK. v.emery@rfc.ucl.ac.uk
Hassan-Walker
Aycan F
AF
Burroughs
Andrew K
AK
Griffiths
Paul D
PD
D017088:AIDS-Related Opportunistic Infections / Q000821:virology*; D003587:Cytomegalovirus / Q000254:growth & development*; D003586:Cytomegalovirus Infections / Q000821:virology*; D004279:DNA, Viral / Q000096:biosynthesis; D006801:Humans; D016031:Liver Transplantation; D014779:Virus Replication
D004279:DNA, Viral