title: T-lymphocyte subsets in lung transplant recipients: association between nadir CD4 T-cell count and viral infections after transplantation.
abstract: BACKGROUND
  Little is known about the kinetics of T-cell subsets in lung transplant recipients (LTR) and their association with the occurrence of opportunistic infections (OI).
  
  
  OBJECTIVE
  To analyze the kinetics of T-lymphocyte subsets in LTR and the association between nadir CD4 T-cell count and viral infections after transplantation.
  
  
  METHODS
  Serial measurements of peripheral blood CD4 and CD8 T-cell counts obtained during the first year post-transplantation from 83 consecutive LTR and their correlation with both viral OI and community-acquired infections post-transplantation were retrospectively analyzed.
  
  
  RESULTS
  LTR with a nadir CD4 T-cell count <200 cells/μl had consistently lower CD4 and CD8 T-cell counts than LTR with a nadir CD4 T-cell count >200 cells/μl (p<0.001). In LTR with a nadir CD4 T-cell count <200 cells/μl, the cumulative incidence of viral infections detected in peripheral blood and in bronchoalveolar lavage (BAL) samples was higher than in LTR with a nadir CD4 T-cell count >200 cells/μl (p=0.0012 and p=0.0058, respectively). A nadir CD4 T-cell count <200 cells/μl within the first three months post-transplantation predicted a higher frequency of viral infectious episodes in BAL samples within the subsequent six month period (p=0.0066).
  
  
  CONCLUSIONS
  Stratification of patients according to nadir CD4 T-cell count may represent a new and simple approach for early identification of patients at risk for subsequent virus infections.
authors.affiliation: Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Via Taramelli 5, 27100 Pavia, Italy.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Calarota
authors.affiliation: Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Via Taramelli 5, 27100 Pavia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Chiesa
authors.affiliation: Biometry and Clinical Epidemiology Department, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: De Silvestri
authors.affiliation: Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Morosini
authors.affiliation: Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy.
authors.forename: Tiberio
authors.initials: T
authors.lastname: Oggionni
authors.affiliation: Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Via Taramelli 5, 27100 Pavia, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Marone
authors.affiliation: Division of Respiratory Diseases, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy; Department of Molecular Medicine, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Meloni
authors.affiliation: Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Via Taramelli 5, 27100 Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100 Pavia, Italy. Electronic address: f.baldanti@smatteo.pv.it.
authors.forename: Fausto
authors.initials: F
authors.lastname: Baldanti
mesh_terms: D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology* / Q000821:virology; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism; D017714:Community-Acquired Infections / Q000097:blood / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D005260:Female; D006801:Humans; D015994:Incidence; D016040:Lung Transplantation / Q000009:adverse effects*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000097:blood / Q000453:epidemiology / Q000276:immunology* / Q000821:virology; D011237:Predictive Value of Tests; D016176:T-Lymphocyte Subsets / Q000378:metabolism*
keywords: Community-acquired viral infections; Lung transplant recipients; Nadir CD4 T cells; Opportunistic viral infections; T-cell subsets