Comparison of the T-cell response to human cytomegalovirus (HCMV) as detected by cytokine flow cytometry and QuantiFERON-CMV assay in HCMV-seropositive kidney transplant recipients

Elisa Gabanti, Daniele Lilleri, Lucia Scaramuzzi, Paola Zelini, Teresa Rampino, Giuseppe Gerna

Research output: Contribution to journalArticlepeer-review

Abstract

Human cytomegalovirus (HCMV)-specific T-cell response in kidney transplant recipients (KTR) helps to identify patients at risk for severe infection. To assess the T-cell response, this study compared our in-house developed reference test, based on T-cell (both CD4+ and CD8+) stimulation by autologous HCMV-infected dendritic cells (iDC) and subsequent detection by cytokine flow cytometry (CFC-iDC), with the Quanti-FERON-CMV (QF-CMV) assay. Fifty-three HCMV-seropositive KTR were enrolled. At the DNAemia peak, 33 (62%) had low viral load (LVL, <3x105 DNA copies/mL) self-resolving infection, 19 (36%) high viral load (HVL, >3x105 DNA copies/mL) infection treated with antivirals, and one LVL patient (2%) tissue-invasive disease alone. Both assays showed a delayed recovery of HCMV-specific T-cell immunity in HVL vs LVL patients. Immune reconstitution kinetics did not significantly differ between the two assays in HVL patients. QF-CMV and CFC-iDC showed comparable sensitivities, but QF-CMV had a lower (although not significantly) specificity. Indeed, 7/19 HVL patients (37%) were erroneously considered protected from severe infection by QF-CMV, whereas CFC-iDC misidentified only 3/19 (16%) patients as protected. Although our reference test takes longer to complete, it appears slightly better at predicting patients at risk for severe HCMV infection. Moreover, QF-CMV May provide false negative results with some HLA types.

Original languageEnglish
Pages (from-to)195-202
Number of pages8
JournalNew Microbiologica
Volume41
Issue number3
Publication statusPublished - Jul 1 2018
Externally publishedYes

Keywords

  • Cytokine flow cytometry
  • Human cytomegalovirus
  • Kidney transplant recipients
  • QuantiFERON-CMV assay
  • T-cell response

ASJC Scopus subject areas

  • Microbiology (medical)

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