title: HLA and killer cell immunoglobulin-like receptors influence the natural course of CMV infection.
abstract: BACKGROUND
  Natural killer (NK) cells provide a major defense against cytomegalovirus (CMV) infection through the interaction of their surface receptors, including the activating and inhibitory killer immunoglobulin-like receptors (KIRs), and human leukocyte antigens (HLA) class I molecules. This study assessed whether the KIR and HLA repertoire may influence the risk of developing symptomatic or asymptomatic disease after primary CMV infection in the immunocompetent host.
  
  
  METHODS
  Sixty immunocompetent patients with primary symptomatic CMV infection were genotyped for KIR and their HLA ligands, along with 60 subjects with a previous asymptomatic infection as controls.
  
  
  RESULTS
  The frequency of the homozygous A haplotype (only KIR2DS4 as activating KIR) was higher in symptomatic patients than controls (30% vs 12%, respectively; odds ratio [OR] = 3.24; P = .01). By logistic regression, the risk of developing symptomatic disease was associated with the homozygous A haplotype and the HLABw4(T) allele. Combining the 2 independent variables, we found that 37 out of 60 (62%) symptomatic patients but only 18 out of 60 (30%) of controls possessed the homozygous A haplotype or the HLABw4(T) allele with a highly significant OR (OR = 3.75, P < .0005).
  
  
  CONCLUSIONS
  Immunocompetent subjects carrying the homozygous A haplotype or the HLABw4(T) allele are at higher risk of developing symptomatic disease after primary CMV infection.
authors.affiliation: Unità Operativa di Medicina Trasfusionale, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" Palermo Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi, Università di Palermo.
authors.forename: Danilo
authors.initials: D
authors.lastname: Di Bona
authors.affiliation: Istituto di Biomedicina ed Immunologia Molecolare, Consiglio Nazionale delle Ricerche.
authors.forename: Valeria
authors.initials: V
authors.lastname: Scafidi
authors.affiliation: Dipartimento di Scienze Matematiche Statistiche e Aziendali, Università di Palermo.
authors.forename: Antonella
authors.initials: A
authors.lastname: Plaia
authors.affiliation: Dipartimento di Scienze per la Promozione della Salute e Materno Infantile "G. D'Alessandro", Università di Palermo.
authors.forename: Claudia
authors.initials: C
authors.lastname: Colomba
authors.affiliation: Istituto di Biomedicina ed Immunologia Molecolare, Consiglio Nazionale delle Ricerche.
authors.forename: Domenico
authors.initials: D
authors.lastname: Nuzzo
authors.affiliation: Unità Operativa di Malattie Infettive, Ospedali Riuniti Villa Sofia-Cervello.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Occhino
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo.
authors.forename: Antonino
authors.initials: A
authors.lastname: Tuttolomondo
authors.affiliation: Dipartimento di Scienze per la Promozione della Salute e Materno Infantile "G. D'Alessandro", Università di Palermo.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Giammanco
authors.affiliation: Dipartimento di Scienze per la Promozione della Salute e Materno Infantile "G. D'Alessandro", Università di Palermo.
authors.forename: Simona
authors.initials: S
authors.lastname: De Grazia
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montalto
authors.affiliation: Istituto di Biomedicina ed Immunologia Molecolare, Consiglio Nazionale delle Ricerche.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Duro
authors.affiliation: Department of Molecular Medicine, Istituto Pasteur-Fondazione Cenci Bolognetti, Sapienza University of Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cippitelli
authors.affiliation: Unità Operativa di Medicina Trasfusionale, Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" Palermo Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi, Università di Palermo.
authors.forename: Calogero
authors.initials: C
authors.lastname: Caruso
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000276:immunology* / Q000473:pathology*; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D015395:Histocompatibility Antigens Class I / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054340:Receptors, KIR / Q000235:genetics / Q000276:immunology / Q000378:metabolism*; D055815:Young Adult
chemical_list: D015395:Histocompatibility Antigens Class I; D054340:Receptors, KIR
keywords: HLA; KIR; cytomegalovirus