title: Cytomegalovirus-specific immunity and protection against viremia and disease in HIV-infected patients in the era of highly active antiretroviral therapy.
abstract: 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.
authors.affiliation: University of Colorado School of Medicine, Denver, 80262, USA. adriana.weinberg@uchsc.edu
authors.forename: Adriana
authors.initials: A
authors.lastname: Weinberg
authors.forename: Camlin
authors.initials: C
authors.lastname: Tierney
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Kendall
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Bosch
authors.forename: Julie
authors.initials: J
authors.lastname: Patterson-Bartlett
authors.forename: Alejo
authors.initials: A
authors.lastname: Erice
authors.forename: Martin S
authors.initials: MS
authors.lastname: Hirsch
authors.forename: Bruce
authors.initials: B
authors.lastname: Polsky
mesh_terms: 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
chemical_list: D007371:Interferon-gamma