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dc.contributor.authorRogers, R.
dc.contributor.authorSaharia, K.
dc.contributor.authorChandorkar, A.
dc.date.accessioned2020-02-21T13:57:32Z
dc.date.available2020-02-21T13:57:32Z
dc.date.issued2020
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85077972778&doi=10.1186%2fs12879-020-4787-4&partnerID=40&md5=3b41c369f7cfe31f433dafb3fed3ec69
dc.identifier.urihttp://hdl.handle.net/10713/12057
dc.description.abstractBackground: Cytomegalovirus (CMV) infection is one of the most common opportunistic infections following organ transplantation, despite administration of CMV prophylaxis. CMV-specific T-cell immunity (TCI) has been associated with reduced rates of CMV infection. We describe for the first time clinical experience using the CMV T-Cell Immunity Panel (CMV-TCIP), a commercially available assay which measures CMV-specific CD4+ and CD8+ T-cell responses, to predict clinically significant CMV events. Methods: Adult (> 18-year-old) patients with CMV-TCIP results and ≥ 1 subsequent assessment for CMV DNAemia were included at Brown University and the University of Maryland Medical Center-affiliated hospitals between 4/2017 and 5/2019. A clinically significant CMV event was defined as CMV DNAemia prompting initiation of treatment. We excluded indeterminate results, mostly due to background positivity, allogeneic hematopoetic cell transplant (HCT) recipients, or patients who were continued on antiviral therapy against CMV irrespective of the CMV-TCIP result, because ongoing antiviral therapy could prevent a CMV event. Results: We analyzed 44 samples from 37 patients: 31 were solid organ transplant recipients, 4 had hematologic malignancies, 2 had autoimmune disorders. The CMV-protection receiver operating characteristic (ROC) area under the curve (AUC) was significant for %CMV-specific CD4+ (AUC: 0.78, P < 0.001) and borderline for CD8+ (AUC: 0.66, P = 0.064) T-cells. At a cut-off value of 0.22% CMV-specific CD4+ T-cells, positive predictive value (PPV) for protection against CMV was 85% (95%CI 65–96%), and negative predictive value (NPV) was 67% (95%CI 41–87%). Conclusions: The CMV-TCIP, in particular %CMV-specific CD4+ T-cells, showed good diagnostic performance to predict CMV events. The CMV-TCIP may be a useful test in clinical practice, and merits further validation in larger prospective studies. Copyright 2020 The Author(s).en_US
dc.description.urihttps://doi.org/10.1186/s12879-020-4787-4en_US
dc.language.isoen_USen_US
dc.publisherBioMed Central Ltd.en_US
dc.relation.ispartofBMC Infectious Diseases
dc.subject(val)gancicloviren_US
dc.subjectCMVen_US
dc.subjectCytomegalovirusen_US
dc.subjectImmunoassaysen_US
dc.subjectTransplantationen_US
dc.titleClinical experience with a novel assay measuring cytomegalovirus (CMV)-specific CD4+ and CD8+ T-cell immunity by flow cytometry and intracellular cytokine staining to predict clinically significant CMV eventsen_US
dc.typeArticleen_US
dc.identifier.doi10.1186/s12879-020-4787-4
dc.identifier.pmid31952516


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