Manuel Oriol
Infectious Diseases Service and Transplantation Center, University Hospital (CHUV) and University of Lausanne, MP14-316. CHUV, 1011, Lausanne, Switzerland,
Curr Infect Dis Rep. 2013 Sep 29. doi: 10.1007/s11908-013-0369-6.
Novel strategies are needed to further reduce the burden of cytomegalovirus (CMV) disease in solid-organ transplant (SOT) recipients. Measurement of the specific cell-mediated immunity against CMV can identify the actual risk for the development of CMV disease in a given patient. Thus, immune monitoring is an attractive strategy for individualizing the management of CMV after transplantation. A growing number of observational studies on immune monitoring for CMV have been published over recent years, although there is a lack of data coming from interventional trials. In high-risk patients, measurement of CMV-specific T-cell responses appropriately stratifies the risk of CMV disease after discontinuation of antiviral prophylaxis. Immune monitoring may also help to identify patients followed by the preemptive approach at low risk for progression to CMV disease. Pretransplant assessment of cell-mediated immunity in seropositive patients may predict the development of posttransplant CMV infection. Overall, these studies indicate that the use of cell-mediated immunity assays has the potential to improve the management of CMV disease in SOT recipients.
需要新的策略来进一步减轻实体器官移植（SOT）受者的巨细胞病毒（CMV）疾病负担。检测针对CMV的特异性细胞介导免疫可以确定特定患者发生CMV疾病的实际风险。因此，免疫监测是移植后个性化管理CMV的一种有吸引力的策略。近年来，关于CMV免疫监测的观察性研究越来越多，尽管缺乏来自干预试验的数据。在高危患者中，检测CMV特异性T细胞反应可适当分层抗病毒预防停药后CMV疾病的风险。免疫监测还可能有助于识别采用抢先治疗方法且进展为CMV疾病风险较低的患者。血清反应阳性患者移植前的细胞介导免疫评估可能预测移植后CMV感染的发生。总体而言，这些研究表明，使用细胞介导免疫测定法有可能改善SOT受者CMV疾病的管理。
