Abstract
Purpose of Review
Immune monitoring to determine when and how the recovery of cytomegalovirus (CMV)-specific T-cells occurs post-transplantation may help clinicians to risk stratify individuals at risk of complications from CMV. We aimed to review all recent clinical studies using CMV immune monitoring in the pre- and post-transplant setting including the use of recently developed standardized assays (Quantiferon-CMV and the CMV ELISPOT) to better understand in whom, when, and how immune monitoring is best used.
Recent Findings
Pre-transplant assessment of CMV immunity in solid-organ transplant recipients where CMV seropositive recipients had undetectable cell-mediated responses despite past immunity has shown that they are at a much higher risk of developing CMV reactivation. Post-transplant CMV immune monitoring can guide (shorten or prolong) the duration of antiviral prophylaxis, identify recipients at risk of post-prophylaxis CMV disease, and predict recurrent CMV reactivation.
Summary
Thus, CMV immune monitoring, in addition to current clinical and DNA-based monitoring for CMV, has the potential to be incorporated into routine clinical care to better improve CMV management in both the stem and solid-organ transplant population.
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Dr. Manuel has received research grants from Lophius Biosciences GmbH and from Qiagen. Dr. Yong and Dr. Lewin declare no conflict of interest.
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This article is part of the Topical Collection on Transplant and Oncology
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Yong, M.K., Lewin, S.R. & Manuel, O. Immune Monitoring for CMV in Transplantation. Curr Infect Dis Rep 20, 4 (2018). https://doi.org/10.1007/s11908-018-0610-4
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DOI: https://doi.org/10.1007/s11908-018-0610-4