title: Adequate control of primary EBV infection and subsequent reactivations after cardiac transplantation in an EBV seronegative patient.
abstract: EBV seronegative recipients of cardiac transplantation are at risk for development of post transplant lymphoproliferative disease following primary EBV infection due to the ongoing treatment with immunosuppressive drugs. Here we present detailed kinetics of the EBV-specific T-cell response following cardiac transplantation in an EBV seronegative recipient who developed a primary EBV infection 15weeks post transplantation and subsequent viral reactivations throughout follow up. The patient developed an EBV-specific CD8(+) T-cell response within 24days after first detection of the primary infection. Subsequently, an increased EBV-specific CD8(+) T-cell response developed upon viral reactivation, indicated by a threefold increase of EBV-specific CD8(+) T cells and increased IFNy production after stimulation with EBV-specific peptide pools. These data indicate that an EBV-specific T-cell response capable of adequate control of a primary EBV-infection and subsequent viral reactivations can develop in an EBV seronegative cardiac transplant recipient in the presence of severe immunosuppression.
authors.affiliation: Department of Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: F L
authors.initials: FL
authors.lastname: Pietersma
authors.forename: A
authors.initials: A
authors.lastname: van Oosterom
authors.forename: L
authors.initials: L
authors.lastname: Ran
authors.forename: R
authors.initials: R
authors.lastname: Schuurman
authors.forename: E
authors.initials: E
authors.lastname: Meijer
authors.forename: N
authors.initials: N
authors.lastname: de Jonge
authors.forename: D
authors.initials: D
authors.lastname: van Baarle
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D020031:Epstein-Barr Virus Infections / Q000276:immunology* / Q000821:virology; D016027:Heart Transplantation / Q000276:immunology*; D004854:Herpesvirus 4, Human / Q000276:immunology* / Q000502:physiology; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007371:Interferon-gamma / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D014775:Virus Activation
chemical_list: D000914:Antibodies, Viral; D007166:Immunosuppressive Agents; D007371:Interferon-gamma