Cytomegalovirus-specific Immunity and Protection Against Viremia and Disease in HIV-infected Patients in the Era of Highly Active Antiretroviral Therapy

J Infect Dis. 2006 Feb 15;193(4):488-93. doi: 10.1086/499826. Epub 2006 Jan 3.

Abstract

To define the immune correlates of protection against cytomegalovirus (CMV) end-organ disease, CMV-specific interferon (IFN)- gamma enzyme-linked immunospot (ELISPOT) and CD8(+) and CD4(+) intracellular IFN- gamma synthesis assays were performed for subjects with CD4(+) cell counts of < or =50 cells/ microL who were enrolled in a prospective observational study of CMV infection in the era of highly active antiretroviral therapy. Of 87 subjects, 46 developed viremia, 14 developed end-organ disease, and 20 died. Positive ELISPOT assay results, but not positive results for CD4(+) or CD8(+) intracellular IFN- gamma synthesis, were associated with delayed development of viremia and CMV end-organ disease or death. CMV viremia did not appear to boost CMV-specific immunity. ELISPOT assays may be used to identify HIV-infected patients who might benefit from anti-CMV prophylactic interventions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • AIDS-Related Opportunistic Infections / immunology
  • AIDS-Related Opportunistic Infections / virology*
  • Adult
  • Antiretroviral Therapy, Highly Active / methods
  • CD4-Positive T-Lymphocytes / immunology
  • CD8-Positive T-Lymphocytes / immunology
  • Cytomegalovirus / immunology*
  • Cytomegalovirus Infections / epidemiology
  • Cytomegalovirus Infections / immunology*
  • Cytomegalovirus Infections / mortality
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology
  • HIV Infections / mortality
  • HIV Infections / virology
  • HIV-1 / immunology*
  • Humans
  • Interferon-gamma / immunology
  • Male
  • Multicenter Studies as Topic
  • Prospective Studies
  • Viremia / epidemiology
  • Viremia / mortality

Substances

  • Interferon-gamma