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Review
. 2021 May 1;13(5):816.
doi: 10.3390/v13050816.

CMV-Specific Cell-Mediated Immunity in Immunocompetent Adults with Primary CMV Infection: A Case Series and Review of the Literature

Angela Chiereghin  1   2 , Gabriella Verucchi  3 , Tiziana Lazzarotto  4
Affiliations
Review

CMV-Specific Cell-Mediated Immunity in Immunocompetent Adults with Primary CMV Infection: A Case Series and Review of the Literature

Angela Chiereghin et al. Viruses. .

Abstract

Cytomegalovirus-specific cell-mediated immunity (CMV-CMI) in actively infected healthy immunocompetent hosts has been poorly investigated. Conversely, correlates of maternal protective immunity for the fetus after primary infection in pregnancy continue to be studied. The kinetics and magnitude of CMV-specific CMI in immunocompetent primary CMV-infected adults are described. A literature review on CMV-CMI in primarily infected pregnant women and its correlation to the risk of vertical virus transmission is included. Immunological measurements after infection were performed by enzyme-linked ImmunoSPOT assay enumerating IFN-γ secreting CMV-specific T cells, at a single cell level, upon in vitro stimulation with viral antigens. Simultaneously, serological and virological profiles of infected patients were investigated. Patients displayed mild-to-moderate clinical and laboratory profiles for infection, and all showed positive EliSpot results in the early stage of infection (<20 days after onset). The virus-CMI was strong in the majority of patients (58.8%) in which the lowest CMV-DNAemia levels (<300 copies/mL) were detected. Significantly higher viral loads were observed in patients with weak CMV-CMI at the same time-point post-infection (up to 15,104 copies/mL; p < 0.001). T cell response magnitudes to IE-1 and pp65-UL83 peptides were overlapping and stable over time. In these case series, the early presence of CMV-CMI was probably pivotal in controlling viral replication and led to spontaneous viral clearance.

Keywords: correlates of maternal protective immunity for the fetus; immunocompetent adults; primary CMV infection; virus-specific cell-mediated immunity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kinetics of antibody responses during the three-month follow-up after primary CMV infection: (a) anti-CMV IgG and (b) IgM in serum samples; (c) IgG avidity index.
Figure 2
Figure 2
Number of cells reactive with CMV peptides during the three-month follow-up after primary CMV infection: (a) pp65-UL83 and (b) IE1. The line indicates the median value. SFCs, spot-forming cells; PBMCs, peripheral blood mononuclear cells.
Figure 3
Figure 3
CMV-DNAemia values during the three-month follow-up after primary CMV infection.
See this image and copyright information in PMC

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