MONITORING OF CYTOMEGALOVIRUS INFECTIONS BY THE CD8+CD38+ T-CELL SUBSET IN KIDNEY TRANSPLANT RECIPIENTS

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Abstract
Background. The CD8+CD38+T-cell subset can predict progression to acquired immune deficiency syndrome among human immunodeficiency virus-positive subjects. This T-cell subset usually increases during other active viral infections (cytomegalovirus[CMV], Epstein Barr virus). We report on its usefulness in the early detection of CMV infection in kidney transplant recipients. Methods. Quantitation of CD8+CD38+T cells was monitored by dual-color flow cytometry analysis on 77 patients during the posttransplantation period. Seventeen of the 52 patients at risk for CMV disease (33%) had primary infection or reactivation and three patients had herpes simplex virus infection only. Results. In every patient with CMV disease, high values for the CD8+CD38+subset were detected with a 90% positive predictive value for the primary infections. Elevated values were observed at the very first clinical signs of the viral disease or within the few preceeding days. Acute rejection episodes did not provoke false-positive results. Conclusion. This immunologic marker is sensitive and easily obtainable on a daily basis. It may help to direct therapy during rejection or serve as a tool for early detection of clinical viral diseases.