gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Testing of CMV-specific interferon-γ release in whole blood is not predictive for the development of CMV viremia in kidney and stem cell transplant patients

Fehlende Vorhersage einer CMV-Virämie durch einen CMV-QuantiFERON Vollblut Test bei Patienten nach Nieren- und Stammzelltransplantation

Meeting Abstract

  • K. Haug - University of Freiburg, Department of Medicine, Division of Infectious Diseases, Freiburg, Germany
  • B. Lange - University of Freiburg, Department of Medicine, Division of Infectious Diseases, Freiburg, Germany; University of Freiburg, Department of Medicine, IFB-Centre of Chronic Immunodeficiency, Freiburg, Germany
  • D. Huzly - University of Freiburg, Institute for Medical Microbiology and Hygiene, Department of Virology, Freiburg, Germany
  • M. Vavra - University of Freiburg, Department of Medicine, Division of Infectious Diseases, Freiburg, Germany; University of Freiburg, Department of Medicine, IFB-Centre of Chronic Immunodeficiency, Freiburg, Germany
  • M. Geyer - University of Freiburg, Department of Nephrology, University Hospital, Freiburg, Germany
  • H. Bertz - University of Freiburg, Department of Hematology & Oncology, University Hospital, Freiburg, Germany
  • P. Pisarski - University of Freiburg, Department of General and Visceral Surgery, Division of Transplantation Surgery, Freiburg, Germany
  • J. Finke - University of Freiburg, Department of Hematology & Oncology, University Hospital, Freiburg, Germany
  • W. V. Kern - University of Freiburg, Department of Medicine, Division of Infectious Diseases, Freiburg, Germany; University of Freiburg, Department of Medicine, IFB-Centre of Chronic Immunodeficiency, Freiburg, Germany
  • D. Wagner - University of Freiburg, Department of Medicine, Division of Infectious Diseases, Freiburg, Germany; University of Freiburg, Department of Medicine, IFB-Centre of Chronic Immunodeficiency, Freiburg, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocINF 13-4

DOI: 10.3205/10kit027, URN: urn:nbn:de:0183-10kit0276

Veröffentlicht: 2. Juni 2010

© 2010 Haug et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Cytomegalovirus (CMV) reactivation remains a significant cause of morbidity both in kidney (KTR) and hematopoietic stem cell transplantation recipients (HCTR). A diminished CMV-specific T-cell response might be a better predictor of CMV reactivation compared to plasma viremia. We hypothesized that patients (pts) with negative or indeterminate results of QuantiFERON-CMV whole blood assay (C-QFT, Cellestis, Australia) would be at greater risk for reactivation of CMV disease due to impaired or absent CMV-specific cellular immunity.

Methods: We prospectively performed C-QFT in 48 healthy controls and 198 pts (KTR n=91; HCTR n=107, table) before and within 1 year after transplantation. After exclusion of D-/R- pts, charts of 152 pts were retrospectively evaluated for CMV viremia (cut-off, 1000 copies/ml plasma) or CMV-therapy. Kaplan-Meier curves and Cox regression were computed to assess viremia-free follow-up according to different C-QFT results. Logistic regression analysis identified risk factors for CMV viremia/antiviral therapy.

Results: C-QFT was positive in 13/17 (77%) CMV-seropos. and negative in 28/31 (90%) CMV-seroneg. controls, respectively. In 69/78 (88%) tests performed in D-/R- pts (19/21=90% in KTR, 50/57=88% in HCTR) C-QFT was negative. 76 pts (50%) had either negative or indeterminate C-QFT and in 76 (50%) pts the C-QFT result was positive. 69 (45%) pts developed viremia at any point after C-QFT, 51% in negative or indeterminate C-QFT pts compared to 40% in pts with positive C-QFT (x2 p>0.05). 35/61 pts that were tested with C-QFT before or 1 month after transplantation had a negative or indeterminate results. 13 (37%) of those developed viremia in the next 100 days compared to 13/26 (50%) with a positive C-QFT result (x2 p>0.05, Figure 1 [Fig. 1]). There was no significant difference in CMV reactivation according to C-QFT status in different transplant or risk groups. In regression analyses C-QFT negative or indeterminate results were not associated with viremia or indication for therapy.

Discussion: We found no association of C-QFT results with subsequent CMV reactivation in KTR and HCTR.


References

1.
Kumar D, Chernenko S, Moussa G, Cobos I, Manuel O, Preiksaitis J, Venkataraman S, Humar A. Cell-mediated immunity to predict cytomegalovirus disease in high-risk solid organ transplant recipients. Am J Transplant. 2009;9(5):1214-22. DOI: 10.1111/j.1600-6143.2009.02618.x Externer Link