title: Evaluation of CMV-specific cellular immune response by EliSPOT assay in kidney transplant patients.
abstract: BACKGROUND
  Immunological monitoring for CMV can be useful in transplant patients; however, few centers perform it on a routine basis.
  
  
  OBJECTIVE
  In this study, CMV-specific cellular response was evaluated in a population of kidney transplant recipients and related to viral infection/reactivation and other demographic and clinical features.
  
  
  METHODS
  Three hundred and twenty-eight patients were studied by EliSPOT assay: 201 prospectively monitored in the first year posttransplantation, 127 with a single determination at >1 year. Clinical features, including occurrence of CMV-DNAemia, CMV serostatus, anti-viral strategies and immunosuppressive protocols, were evaluated.
  
  
  RESULTS
  Overall, 66.5% of patients were CMV-responders at EliSPOT assay. No episode of infection occurred at follow-up (mean 24.5 months) in 73.4% responders versus 55.5% non-responders (p<0.005); CMV-free period was significantly longer in responders (p<0.001). Although no significant difference of peak viral load was found, prevalence of CMV-DNAemia values >10(5)copies/mL was significantly higher in non-responders versus responders (8.2% and 2.3%, p<0.05). Non-responder status was significantly associated to CMV-seronegativity (p<0.0001), anti-viral prophylaxis use (p<0.0001), and immunosuppression induction with basiliximab (p<0.005). No significant association was found for other clinical features and immunosuppressive protocols.
  
  
  CONCLUSIONS
  Immunological data for CMV could be used in the clinical evaluation and decision-making process, in combination with virological monitoring, in kidney transplant recipients.
authors.affiliation: Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy. Electronic address: ccosta2@cittadellasalute.to.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Costa
authors.affiliation: Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Balloco
authors.affiliation: Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Sidoti
authors.affiliation: Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Samantha
authors.initials: S
authors.lastname: Mantovani
authors.affiliation: Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Rittà
authors.affiliation: Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Piceghello
authors.affiliation: Renal Transplant Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fop
authors.affiliation: Renal Transplant Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Messina
authors.affiliation: Microbiology and Virology Unit, Laboratory of Virology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Turin, Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: Cavallo
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000276:immunology*; D058501:Enzyme-Linked Immunospot Assay; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D066027:Transplant Recipients
keywords: CMV-DNAemia; Cellular immune response; Cytomegalovirus; EliSPOT assay; Kidney transplantation