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Clinical applications of interferon-γ releasing assays for cytomegalovirus to differentiate cytomegalovirus disease from bystander activation: a pilot proof-of-concept study
- Source :
- The Korean Journal of Internal Medicine
- Publication Year :
- 2017
- Publisher :
- Korean Association of Internal Medicine, 2017.
-
Abstract
- Background/aims We evaluated the proposed clinical application of the combined interpretation of host factors and viral factors in two different cytomegalovirus (CMV) co-infection models. Methods We prospectively enrolled all human immunodeficiency virus non-infected patients with confirmed Pneumocystitis jirovecii pneumonia (PCP) and those with suspected gastrointestinal CMV disease in a tertiary hospital. All patients underwent CMV interferon-γ releasing assay (IGRA) for CMV (T-track CMV, Lophius Biosciences). We created the 2-axis model with the CMV IGRA results as the x-axis and the results for CMV virus replication as the y-axis, and hypothesized that cases falling in the left upper quadrant (high viral load and low CMV-specific immunity) of the model would be true CMV infections. The CMV IGRA results were concealed from the attending physicians. Results Of 39 patients with PCP, four (10%) were classified as combined CMV pneumonia, 13 (33%) as bystander activation, and the remaining 22 (56%) as no CMV infection. The data for all four patients with PCP and CMV pneumonia fell in the left upper quadrant of the 2-axis model. Of 24 patients with suspected gastrointestinal CMV disease, 12 (50%) were classified as gastrointestinal CMV disease and the remaining 12 (50%) as bystander activation with no gastrointestinal CMV disease. The data for 11 of the 12 patients (92%) with gastrointestinal CMV disease were located in the left upper quadrant of the 2-axis model. Conclusions Cases yielding low CMV IGRA results and high CMV viral replication appear to be true CMV infections. Further studies with large number of cases in different types of CMV disease should be proposed.
- Subjects :
- Adult
Male
0301 basic medicine
Enzyme-Linked Immunospot Assay
Pneumonia, Viral
030106 microbiology
Cytomegalovirus
Pilot Projects
Pneumocystis carinii
medicine.disease_cause
Proof of Concept Study
Immunocompromised Host
Interferon-gamma
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Immunity
medicine
Humans
Viral load
Interferon gamma
Prospective Studies
Prospective cohort study
Coinfection
business.industry
Pneumonia, Pneumocystis
virus diseases
Bystander Effect
Middle Aged
medicine.disease
Pneumonia
Infectious Diseases
Viral replication
Cytomegalovirus Infections
Host-Pathogen Interactions
Immunology
Original Article
Female
Virus Activation
030211 gastroenterology & hepatology
business
Biomarkers
Interferon-gamma Release Tests
medicine.drug
Subjects
Details
- ISSN :
- 20056648 and 12263303
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- The Korean Journal of Internal Medicine
- Accession number :
- edsair.doi.dedup.....847ff3517674de5756a1cf408d1e6a10