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

Daniele Lilleri, Giampiero Piccinini, Emilia Genini, Giuditta Comolli, Antonella Chiesa, Federica Tordato, Giovanni Sotgiu, Aldo Parisi, Fausto Baldanti, Maria Grazia Revello, Giuseppe Gerna

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)297-307
Number of pages11
JournalJournal of Clinical Virology
Volume29
Issue number4
DOIs
Publication statusPublished - Apr 2004

Keywords

  • AIDS
  • CD4 T cells
  • Cytokine flow cytometry
  • HAART
  • HCMV disease
  • HCMV prophylaxis

ASJC Scopus subject areas

  • Applied Microbiology and Biotechnology
  • Virology
  • Immunology and Allergy
  • Infectious Diseases

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