Prognostic effect of lymphocyte subgroup CD4+ and CD8+ cells in peripheral blood in renal transplant patients with cytomegalovirus viremia

Transplant Proc. 2009 Jun;41(5):1639-42. doi: 10.1016/j.transproceed.2009.01.085.

Abstract

Objective: Our aim was to evaluate the prognostic effect of peripheral blood lymphocyte subgroup CD4+ and CD8+ cells on renal transplant patients with cytomegalovirus (CMV) viremia.

Materials and methods: Using 41 renal transplant patients with CMV-PCR(+) in peripheral blood and stable values of serum creatinine (SCr), we evaluated the changes in lymphocyte subgroup CD4+ and CD8+ cells with onset of antiviral therapy with gancyclovir for treatment of pneumonia. We compared patients with or without pneumonia.

Results: The lower the peripheral blood lymphocyte subgroup CD4+ and CD8+ cell numbers, the higher the incidence of CMV pneumonia. The numbers of CD4+ and CD8+ cells at 1 month posttransplantation and at the time of CMV-PCR(+) detection were significantly lower than those before transplantation in the CMV pneumonia group (P < .01) and also in the nonpneumonia group.

Conclusions: The decrease in peripheral blood lymphocyte subgroup CD4+ and CD8+ cells after renal transplantation in patients with CMV viremia showed prognostic value for pneumonia. Increased CD4+ and CD8+ cells in peripheral blood combined with preemptive therapy may reduce the incidence of pneumonia among patients with CMV viremia.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • CD4-Positive T-Lymphocytes / immunology*
  • CD4-Positive T-Lymphocytes / virology
  • CD8-Positive T-Lymphocytes / immunology*
  • CD8-Positive T-Lymphocytes / virology
  • Cytomegalovirus / genetics
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / etiology*
  • Cytomegalovirus Infections / immunology
  • Drug Therapy, Combination
  • Female
  • Ganciclovir / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / immunology*
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Pneumonia / epidemiology
  • Pneumonia / prevention & control
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / immunology
  • Polymerase Chain Reaction
  • Prognosis

Substances

  • Antiviral Agents
  • Immunosuppressive Agents
  • Ganciclovir