TY - JOUR
T1 - Monitoring of human cytomegalovirus (HCMV)-specific CD4+ T cell frequency by cytokine flow cytometry as a possible indicator for discontinuation of HCMV secondary prophylaxis in HAART-treated AIDS patients
AU - Lilleri, Daniele
AU - Piccinini, Giampiero
AU - Genini, Emilia
AU - Comolli, Giuditta
AU - Chiesa, Antonella
AU - Tordato, Federica
AU - Sotgiu, Giovanni
AU - Parisi, Aldo
AU - Baldanti, Fausto
AU - Revello, Maria Grazia
AU - Gerna, Giuseppe
PY - 2004/4
Y1 - 2004/4
N2 - Objective: Absolute CD4+ T cell count and human cytomegalovirus (HCMV)-specific CD4+ T cell frequency (as determined by cytokine flow cytometry, CFC) were compared for their ability to predict HCMV disease and safe discontinuation of HCMV secondary prophylaxis. Study design: Three groups of AIDS patients with previous nadir CD4+ T cell count + T cell count (group C). Results: During follow-up, while some patients showed a stable HCMV-specific CD4+ T cell response, others had a fluctuating response (unstable responders) or showed no response at all. In detail, 13/48 group A patients were either HCMV non-responders or unstable responders and 2 of them developed HCMV viremia; 3/11 group B patients were unstable responders, none developing either HCMV viremia or disease; finally, 9 group C patients discontinued HCMV prophylaxis based on absolute CD4+ T cell count >150cells/μl, but in 2 of them lacking HCMV-specific response HCMV retinitis relapsed. None of the seven group C patients discontinuing HCMV prophylaxis on the basis of CFC showed HCMV disease relapse. Conclusions: CFC may support absolute CD4+ T cell count for both guiding HCMV prophylaxis discontinuation and better monitoring HCMV infection in AIDS patients with no previous HCMV disease or having discontinued HCMV prophylaxis.
AB - Objective: Absolute CD4+ T cell count and human cytomegalovirus (HCMV)-specific CD4+ T cell frequency (as determined by cytokine flow cytometry, CFC) were compared for their ability to predict HCMV disease and safe discontinuation of HCMV secondary prophylaxis. Study design: Three groups of AIDS patients with previous nadir CD4+ T cell count + T cell count (group C). Results: During follow-up, while some patients showed a stable HCMV-specific CD4+ T cell response, others had a fluctuating response (unstable responders) or showed no response at all. In detail, 13/48 group A patients were either HCMV non-responders or unstable responders and 2 of them developed HCMV viremia; 3/11 group B patients were unstable responders, none developing either HCMV viremia or disease; finally, 9 group C patients discontinued HCMV prophylaxis based on absolute CD4+ T cell count >150cells/μl, but in 2 of them lacking HCMV-specific response HCMV retinitis relapsed. None of the seven group C patients discontinuing HCMV prophylaxis on the basis of CFC showed HCMV disease relapse. Conclusions: CFC may support absolute CD4+ T cell count for both guiding HCMV prophylaxis discontinuation and better monitoring HCMV infection in AIDS patients with no previous HCMV disease or having discontinued HCMV prophylaxis.
KW - AIDS
KW - CD4 T cells
KW - Cytokine flow cytometry
KW - HAART
KW - HCMV disease
KW - HCMV prophylaxis
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U2 - 10.1016/S1386-6532(03)00214-2
DO - 10.1016/S1386-6532(03)00214-2
M3 - Article
C2 - 15018859
AN - SCOPUS:10744223665
VL - 29
SP - 297
EP - 307
JO - Journal of Clinical Virology
JF - Journal of Clinical Virology
SN - 1386-6532
IS - 4
ER -