Assessment of Cytomegalovirus-Specific Cell-Mediated Immunity for the Prediction of Cytomegalovirus Disease in High-Risk Solid-Organ Transplant Recipients: A Multicenter Cohort Study.
Late CMV disease occurring after prophylaxis is a significant issue in CMV mismatched transplant recipients and predicting which patients will develop late CMV disease is difficult. In the last few years, immune monitoring has gained significant importance in the management of CMV. In this multicenter, prospective cohort study, the authors followed 127 D+/R- transplant patients and performed the Quantiferon-CMV assay at three timepoints after end of prophylaxis. Those with a positive Quantiferon-CMV assay were significantly less likely to have CMV disease than those with a negative or indeterminate assay result (6.4% vs. 22.2% vs. 58.3%; p<0.001). In the future, immune monitoring will likely be a significant adjunct clinical tool in the management of transplant patients at high risk for CMV.