title: The immunological footprint of CMV in HIV-1 patients stable on long-term ART.
abstract: BACKGROUND
  Most HIV-infected persons are cytomegalovirus (CMV) seropositive and retain latent virus that can be reactivated by immune activation. Their T cell populations express markers reflecting a late stage of differentiation, but the contributions of HIV and CMV to this profile are unclear. We investigated the immunological "footprint" of CMV in HIV patients who had a history of extreme immunodeficiency but were now stable on antiretroviral therapy (ART).
  
  
  RESULTS
  Twenty CMV seropositive HIV patients >50 years old with nadir CD4 T-cell counts <200 cells/μl were studied after >12 years on ART. 16 CMV seropositive and 9 CMV seronegative healthy controls were included. CMV antibody titres were higher in HIV patients than controls (P < 0.001-0.003). Levels of soluble B-cell activating factor (sBAFF) were elevated in patients (P = 0.002) and correlated with levels of CMV antibodies (P = 0.03-0.002), with no clear relationship in controls. CD8 T-cell IFNγ responses to the IE1 peptide (VLE) remained elevated in HIV patients (P = 0.005). The CD57(+)CD45RA(+)CD27(-) phenotype of CD8 T-cells correlated with age (r = 0.60, P = 0.006), antibodies against CMV IE1 protein (r = 0.44, P = 0.06) and CD4 T-cell IFNγ response to CMV lysate (r = 0.45, P = 0.05).
  
  
  CONCLUSIONS
  Humoral and T-cell responses to CMV remained elevated in HIV patients after >12 years on ART. Age and presence of CMV disease influenced CD8 T-cell phenotypes. Elevated levels of sBAFF may be a consequence of HIV disease and contribute to high titres of CMV antibody.
authors.affiliation: School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA Australia ; School of Biomedical Science, Curtin University, GPO Box U1987 Bentley, Perth, WA Australia.
authors.forename: Jacquita S
authors.initials: JS
authors.lastname: Affandi
authors.affiliation: School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA Australia.
authors.forename: Jacinta
authors.initials: J
authors.lastname: Montgomery
authors.affiliation: School of Pathology and Laboratory Medicine, University of Western Australia, Nedlands, WA Australia.
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Brunt
authors.affiliation: Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, WA Australia.
authors.forename: David
authors.initials: D
authors.lastname: Nolan
authors.affiliation: School of Biomedical Science, Curtin University, GPO Box U1987 Bentley, Perth, WA Australia.
authors.forename: Patricia
authors.initials: P
authors.lastname: Price
keywords: ART; Age; CMV; HIV; Immunosenescence