Identifying Cytomegalovirus Complications Using the Quantiferon-CMV Assay After Allogeneic Hematopoietic Stem Cell Transplantation

Michelle K Yong, Paul U. Cameron, Monica Slavin, C Orla Morrissey, Krystal Bergin, Andrew Spencer, David Ritchie, Allen C Cheng, Assia Samri, Guislaine  Carcelain, Brigitte Autran, Sharon R. Lewin

Research output: Contribution to journalArticleResearchpeer-review

24 Citations (Scopus)

Abstract

Background: A simple test to identify recovery of CMV-specific T-cell immunity following hematopoietic stem cell transplantation (HSCT) could assist clinicians in managing CMV-related complications.

Methods: In an observational, multicenter, prospective study of 94 HSCT recipients we evaluated CMV-specific T-cell immunity at baseline, 3, 6, 9, and 12 months after transplant using the Quantiferon-CMV, an enzyme-linked immunosorbent spot assay (ELISpot), and intracellular cytokine staining.

Results: At 3 months after HSCT, participants who developed CMV disease (n = 8) compared with CMV reactivation (n = 26) or spontaneous viral control (n = 25) had significantly lower CD8+ T-cell production of interferon-γ (IFN-γ) in response to CMV antigens measured by Quantiferon-CMV (P = .0008). An indeterminate Quantiferon-CMV result had a positive predictive value of 83% and a negative predictive value of 98% for identifying participants at risk of further CMV reactivation. Participants experiencing CMV reactivation compared with patients without CMV reactivation had a reduced proportion of polyfunctional (IFN-γ+/tumor necrosis factor α-positive) CD4+ and CD8+ T cells and a higher proportion of interleukin 2-secreting cells (P = .01 and P = .002, respectively).

Conclusions: Quantifying CMV-specific T-cell immunity after HSCT can identify participants at increased risk of clinically relevant CMV-related outcomes.

Original languageEnglish
Pages (from-to)1684-1694
Number of pages11
JournalJournal of Infectious Diseases
Volume215
Issue number11
DOIs
Publication statusPublished - 1 Jun 2017

Keywords

  • cytomegalovirus
  • viral immunity
  • stem cell transplantation
  • T-cell immunity
  • immunocompromised host

Cite this