Treatment-dependent loss of polyfunctional CD8+ T-cell responses in HIV-infected kidney transplant recipients is associated with herpesvirus reactivation.
Details
Serval ID
serval:BIB_08C788500378
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Treatment-dependent loss of polyfunctional CD8+ T-cell responses in HIV-infected kidney transplant recipients is associated with herpesvirus reactivation.
Journal
American Journal of Transplantation
ISSN
1600-6143[electronic]
Publication state
Published
Issued date
2009
Volume
9
Number
4
Pages
794-803
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Antiretroviral-therapy has dramatically changed the course of HIV infection and HIV-infected (HIV(+)) individuals are becoming more frequently eligible for solid-organ transplantation. However, only scarce data are available on how immunosuppressive (IS) strategies relate to transplantation outcome and immune function. We determined the impact of transplantation and immune-depleting treatment on CD4+ T-cell counts, HIV-, EBV-, and Cytomegalovirus (CMV)-viral loads and virus-specific T-cell immunity in a 1-year prospective cohort of 27 HIV(+) kidney transplant recipients. While the results show an increasing breadth and magnitude of the herpesvirus-specific cytotoxic T-cell (CTL) response over-time, they also revealed a significant depletion of polyfunctional virus-specific CTL in individuals receiving thymoglobulin as a lymphocyte-depleting treatment. The disappearance of polyfunctional CTL was accompanied by virologic EBV-reactivation events, directly linking the absence of specific polyfunctional CTL to viral reactivation. The data provide first insights into the immune-reserve in HIV+ infected transplant recipients and highlight new immunological effects of thymoglobulin treatment. Long-term studies will be needed to assess the clinical risk associated with thymoglobulin treatment, in particular with regards to EBV-associated lymphoproliferative diseases.
Keywords
Acyclovir/therapeutic use, Adult, Aged, Antiviral Agents/therapeutic use, CD4 Lymphocyte Count, CD4-Positive T-Lymphocytes/immunology, CD8-Positive T-Lymphocytes/immunology, Cell Survival, Cytomegalovirus/genetics, Flow Cytometry, Ganciclovir/therapeutic use, HIV Infections/complications, HIV Infections/drug therapy, HLA-A Antigens/immunology, HLA-B Antigens/immunology, HLA-DR Antigens/immunology, Herpesviridae/drug effects, Herpesviridae/genetics, Herpesvirus 4, Human/drug effects, Herpesvirus 4, Human/genetics, Humans, Kidney Transplantation/immunology, Kidney Transplantation/pathology, Middle Aged, Patient Selection, T-Lymphocytes, Cytotoxic/immunology, T-Lymphocytes, Cytotoxic/pathology, Viral Load, Virus Activation/immunology, Virus Activation/physiology
Pubmed
Web of science
Open Access
Yes
Create date
11/02/2010 17:23
Last modification date
20/08/2019 13:31