CMV Cell-Mediated Immunity Assays Show Promise for Personalizing Transplant Management
This review evaluates multiple techniques for measuring cytomegalovirus-specific T-cell immunity in solid organ transplant recipients, including ELISpot, intracellular cytokine staining, and the QuantiFERON-CMV assay. CMI testing shows potential for determining optimal prophylaxis duration and guiding treatment of low-level viral reactivation. Despite encouraging data, barriers to clinical adoption include lack of standardization and insufficient interventional trial evidence.
The original study
Utility of Cytomegalovirus Cell-Mediated Immunity Assays in Solid Organ Transplantation.
- Authors
- Hall VG, Humar A, Kumar D
- Journal
- Journal of clinical microbiology
- Type
- Journal Article, Review, Research Support, Non-U.S. Gov't
- PMID
- 35543099
Original abstract
Cytomegalovirus (CMV) is one of the most important viral complications after solid organ transplantation (SOT). Current preventive and management strategies rely primarily on serologic and viral load testing and remain suboptimal. To address these issues, multiple techniques to measure CMV-specific cell-mediated immunity (CMI) have been developed and evaluated in clinical studies over the past two decades. These assays show significant promise for the personalization of CMV management. For example, CMI assays can be used to help determine the optimal duration of antiviral prophylaxis or whether antiviral therapy is indicated in patients with low levels of CMV reactivation. However, despite numerous studies showing potential utility, these assays are not yet in widespread routine clinical use. Barriers to adoption include variations in test complexity, standardization, and thresholds for positivity and insufficient interventional clinical trials. Here, we provide an updated assessment of commonly available tests and the clinical utility of CMV-specific CMI testing in SOT recipients.