title: Cytomegalovirus-specific T-cell immunity to assign the infection status in individuals with passive immunity: a proof of principle.
abstract: BACKGROUND
  Serological analysis of the infection status with the human cytomegalovirus (CMV) may be inaccurate after transfusion of blood products due to the variable content of CMV-specific antibodies.
  
  
  OBJECTIVE
  In this situation, analysis of cellular immunity may represent a more accurate parameter to assign the individual CMV-infection status. This hypothesis was assessed in a sequence of clinically defined events where a CMV-seronegative patient received human immunoglobulins before AB0 incompatible transplantation of a graft from his CMV-seropositive mother and developed CMV-primary infection thereafter.
  
  
  METHODS
  Humoral immunity was analyzed using ELISA, and CMV-specific CD4 T-cells were flow-cytometrically quantified using intracellular cytokine staining after a 6 h-stimulation with a CMV-antigen lysate.
  
  
  RESULTS
  Prior to transplantation, both CMV-specific antibody-titers and T-cell frequencies were below detection limit. After plasma infusion, the patient was temporarily seropositive but remained T-cell negative indicating passive immunity. CMV-specific T-cells became stably detectable after graft-related primary infection, thereby confirming a truly positive infection status.
  
  
  CONCLUSIONS
  This case provides an instructive proof of principle to show that CMV-specific CD4 T-cells may serve as an accurate marker to define the true CMV-infection status in situations where serological testing is limited by the presence of passively administered antibodies.
authors.affiliation: Department of Transplant and Infection Immunology, Saarland University, Homburg, Germany.
authors.forename: Tina
authors.initials: T
authors.lastname: Schmidt
authors.forename: Marion
authors.initials: M
authors.lastname: Ritter
authors.forename: Jan
authors.initials: J
authors.lastname: Dirks
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Gärtner
authors.forename: Urban
authors.initials: U
authors.lastname: Sester
authors.forename: Martina
authors.initials: M
authors.lastname: Sester
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D016207:Cytokines / Q000096:biosynthesis; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology*; D014184:Transplantation, Homologous / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D016207:Cytokines