Cytomegalovirus‐Specific Immunity and Protection against Viremia and Disease in HIV‐Infected Patients in the Era of Highly Active Antiretroviral Therapy

Abstract

To define the immune correlates of protection against cytomegalovirus (CMV) end-organ disease, CMV-specific interferon (IFN)-γ)I enzyme-linked immunospot (ELISPOT) and CD8⁺ and CD4⁺ intracellular IFN-γ)I synthesis assays were performed for subjects with CD4⁺ cell counts of ⩽50 cells/µL who were enrolled in a prospective observational study of CMV infection in the era of highly active antiretroviral therapy. Of 87 subjects, 46 developed viremia, 14 developed end-organ disease, and 20 died. Positive ELISPOT assay results, but not positive results for CD4⁺ or CD8⁺ intracellular IFN-γ synthesis, were associated with delayed development of viremia and CMV end-organ disease or death. CMV viremia did not appear to boost CMV-specific immunity. ELISPOT assays may be used to identify HIV-infected patients who might benefit from anti-CMV prophylactic interventions.