Functional impairment of CMV-reactive cellular immunity during pregnancy

J Med Virol. 2017 Feb;89(2):324-331. doi: 10.1002/jmv.24639. Epub 2016 Sep 7.


Cytomegalovirus (CMV) is the most common congenital viral infection. Mother-to-child transmission can cause severe child disability. Intact CMV-specific cell-mediated immunity (CMI) was shown to prevent uncontrolled replication in healthy individuals. This study aimed to determine whether CMV-specific CMI is impaired in pregnant women, thus potentially increasing the overall risk for active CMV replication and transmission. CMV-specific CMI in peripheral blood of 60 pregnant women was determined using T-Track® CMV for detection of IE-1 and pp65-reactive effector cells by IFN-γ ELISpot, and compared to the CMV-IgG and -IgM serostatus. CMV-specific CMI was detected in 65% of CMV-seropositive pregnant women. Five percent of CMV-IgG seronegative women showed IE-1- but not pp65-reactive cells. The overall number of CMV-reactive cells in pregnant women was significantly lower compared to a matched non-pregnant control group (P < 0.001). No significant difference in CMV-specific CMI was detected in the course of the three trimesters of pregnancy of CMV-IgG seropositive women. Postpartum (median days postnatal = 123), IE-1- and pp65-specific CMI remained significantly lower than in the non-pregnant control group (P < 0.001 and 0.0032, respectively). Functional analysis of CMV-reactive immune cells using T-Track® CMV therefore suggests a systemic down-regulation of CMV-specific CMI in pregnant women. Further studies are needed to investigate whether this may be indicative of a higher susceptibility to CMV reactivation or transmission. J. Med. Virol. 89:324-331, 2017. © 2016 Wiley Periodicals, Inc.

Keywords: cell-mediated immunity; cytomegalovirus; interferon (IFN)-γ-enzyme-assay ELISpot; pregnancy.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / blood
  • Antigens, Viral / immunology
  • Cytomegalovirus / immunology*
  • Enzyme-Linked Immunospot Assay
  • Female
  • Humans
  • Immune Tolerance*
  • Immunity, Cellular*
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Interferon-gamma / metabolism
  • Leukocytes, Mononuclear / immunology
  • Middle Aged
  • Pregnancy
  • Young Adult


  • Antibodies, Viral
  • Antigens, Viral
  • Immunoglobulin G
  • Immunoglobulin M
  • Interferon-gamma