Cytomegalovirus-specific immunity and protection against viremia and disease in HIV-infected patients in the era of highly active antiretroviral therapy.
To define the immune correlates of protection against cytomegalovirus (CMV) end-organ disease, CMV-specific interferon (IFN)- gamma enzyme-linked immunospot (ELISPOT) and CD8(+) and CD4(+) intracellular IFN- gamma synthesis assays were performed for subjects with CD4(+) cell counts of < or =50 cells/ microL who were enrolled in a prospective observational study of CMV infection in the era of highly active antiretroviral therapy. Of 87 subjects, 46 developed viremia, 14 developed end-organ disease, and 20 died. Positive ELISPOT assay results, but not positive results for CD4(+) or CD8(+) intracellular IFN- gamma synthesis, were associated with delayed development of viremia and CMV end-organ disease or death. CMV viremia did not appear to boost CMV-specific immunity. ELISPOT assays may be used to identify HIV-infected patients who might benefit from anti-CMV prophylactic interventions.
Weinberg
Adriana
A
University of Colorado School of Medicine, Denver, 80262, USA. adriana.weinberg@uchsc.edu
Tierney
Camlin
C
Kendall
Michelle A
MA
Bosch
Ronald J
RJ
Patterson-Bartlett
Julie
J
Erice
Alejo
A
Hirsch
Martin S
MS
Polsky
Bruce
B
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000821:virology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000276:immunology* / Q000401:mortality; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality / Q000821:virology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007371:Interferon-gamma / Q000276:immunology; D008297:Male; D015337:Multicenter Studies as Topic; D011446:Prospective Studies; D014766:Viremia / Q000453:epidemiology / Q000401:mortality
D007371:Interferon-gamma