Sustained impairment of human cytomegalovirus HCMV-specific CD4 and CD8 T cell response is responsible for recurrent episodes of disseminated HCMV infection in a D R-hand transplant recipientReport as inadecuate




Sustained impairment of human cytomegalovirus HCMV-specific CD4 and CD8 T cell response is responsible for recurrent episodes of disseminated HCMV infection in a D R-hand transplant recipient - Download this document for free, or read online. Document in PDF available to download.

Cases Journal

, 1:155

First Online: 17 September 2008Received: 29 July 2008Accepted: 17 September 2008DOI: 10.1186-1757-1626-1-155

Cite this article as: Baldanti, F., Lucchini, G., Lilleri, D. et al. Cases Journal 2008 1: 155. doi:10.1186-1757-1626-1-155

Abstract

Human cytomegalovirus HCMV infection is the major viral complication in solid organ transplant recipients. Seronegative recipents R of organs from seropositive donors D appear to be at higher risk of developing symptomatic HCMV infection. To what extent systemic life-threatening complications can be risked for non-life-saving transplant procedures? A case report describing successful treatment of repeated episodes of active HCMV infection in a DR hand recipient in the absence of HCMV-specific T-cell immunity is presented. In the attempt to save both the patient and the transplanted hand, a preemptive treatment strategy was adopted with the aim to boost the constitution of the virus-specific T-cell immune response and simultaneously avoid onset of disease. Careful monitoring of HCMV load in blood and HCMV-specific T-cell immunity guided administration of repeated courses of antiviral treatment and avoided emergence of HCMV-related symptoms. Following establishment of HCMV-specific CD4 and CD8 T-cell response, preemptive treatment was no longer required due to sustained HCMV disappearance from blood. The patient is now well, and his hand too. In conclusion, evaluation of virus-specific T-cell immunity is of crucial importance in DR transplant recipients and careful monitoring of HCMV-specific T cell mediated response should always parallel monitoring of HCMV load in transplant recipients.

AbbreviationsHCMVhuman cytomegalovirus

SOTRsolid organs transplant recipients

PCRpolymerase chain reaction

PBMCperipheral blood mononuclear cells

DCdendritic cells

IFNγinterferonγ.

Electronic supplementary materialThe online version of this article doi:10.1186-1757-1626-1-155 contains supplementary material, which is available to authorized users.

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Author: Fausto Baldanti - Giovanna Lucchini - Daniele Lilleri - Marco Lanzetta

Source: https://link.springer.com/







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