title: Factors related to the development of CMV-specific CD8+ T cell response in CMV-seropositive solid organ transplant candidates.
abstract: This cross-sectional study analyzes factors associated with the development of CMV-specific CD8+ response, measured by IFNg production after cytomegalovirus (CMV) peptide stimulation, in CMV-seropositive solid organ transplantation candidates. A total of 114 candidates were enrolled, of whom 22.8% (26/114) were nonreactive (IFNγ < 0.2 IU/mL). Multivariate logistic regression analysis showed that age, HLA alleles and organ to be transplanted were associated with developing CMV-specific CD8+ immunity (reactive; IFNγ ≥ 0.2 IU/mL). The probability of being reactive was higher in candidates over 50 than in those under 50 (OR 6.33, 95%CI 1.93-20.74). Candidates with HLA-A1 and/or HLA-A2 alleles had a higher probability of being reactive than those with non-HLA-A1/non-HLA-A2 alleles (OR 10.97, 95%CI 3.36-35.83). Renal candidates had a higher probability of being reactive than lung (adjusted OR 8.85, 95%CI 2.24-34.92) and liver candidates (OR 4.87, 95%CI 1.12-21.19). The AUC of this model was 0.84 (p < 0.001). Positive and negative predictive values were 84.8% and 76.9%, respectively. In renal candidates longer dialysis was associated with an increased frequency of reactive individuals (p = 0.040). Therefore, although the assessment of CMV-specific CD8+ response is recommended in all R+ candidates, it is essential in those with a lower probability of being reactive, such as non-renal candidates, candidates under 50 or those with non-HLA-A1/non-HLA-A2 alleles.
authors: Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Reina Sofia University Hospital/University of Cordoba, Cordoba, Spain; Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain.
authors: S
authors: S
authors: Cantisán
authors: C
authors: C
authors: Rodelo-Haad
authors: A
authors: A
authors: Páez-Vega
authors: A
authors: A
authors: Nieto
authors: J M
authors: JM
authors: Vaquero
authors: A
authors: A
authors: Poyato
authors: M
authors: M
authors: Montejo
authors: M C
authors: MC
authors: Fariñas
authors: A
authors: A
authors: Rivero
authors: R
authors: R
authors: Solana
authors: A
authors: A
authors: Martín-Malo
authors: J
authors: J
authors: Torre-Cisneros
mesh_terms: D000328:Adult; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D003587:Cytomegalovirus / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation
keywords: Clinical research/practice; cytokines/cytokine receptors; immunobiology; infection and infectious agents; infectious disease; lymphocyte biology: activation; major histocompatibility complex (MHC); organ transplantation in general; translational research/science; viral: Cytomegalovirus (CMV)