• Hélène Moins-Teisserenc, Marc Busson, Catherine Scieux, Véronique Bajzik, Jean-Michel Cayuela, Emmanuel Clave, de LatourRégis PeffaultRP, Félix Agbalika, Patricia Ribaud, Marie Robin, Vanderson Rocha, Eliane Gluckman, Dominique Charron, Gérard Socié, and Antoine Toubert.
• Laboratoire d'Immunologie et d'Histocompatibilité, Centre d'Investigations Biomédicales Hématologie-Oncologie-Greffes, Paris, France. helene.moins@univ-paris-diderot.fr
• J. Infect. Dis. 2008 Sep 15; 198 (6): 818-26.

AbstractT cell-mediated immunity is essential for the control of cytomegalovirus (CMV) infections in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Our aims were to identify patterns of CMV-specific immune responses associated with multiple or prolonged reactivations. We analyzed findings in 116 recipients during the course of infection or reactivation and latency. CD8(+) T cell responses were determined weekly, using HLA class I tetramers together with extended phenotypic analyses. Our results confirmed that recipients of allo-HSCT from unrelated donors were more susceptible to multiple reactivations and that the donor's CMV serological status influenced the occurrence of prolonged reactivations. We found that a lack of CMV-specific T cells after the first episode of reactivation was associated with multiple subsequent reactivations. In patients with uncontrolled reactivations, CMV-specific T cells of the late differentiation phenotype CD45RA(+)CD27(-)CD28(-) did not develop. Longitudinal evaluation of CD27 and CD45RA expression within the tetramer-positive subset could help identify patients in whom a protective immune response is developing. Evaluation of CMV-specific immune responses during the first episode of reactivation, together with extended phenotypes, could thus improve immune monitoring, especially in recipients at risk of uncontrolled viral reactivation.

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