CMV cell–mediated immunity assays: Focus on CD4+ cells

Lerner, Alexis Hope; Farmakiotis, Dimitrios

doi:10.1111/ajt.15866

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…The preemptive treatment approach has the lowest cost in terms of medication expense alone. 25 Moreover, the use of assays that measure CMV-specific T-cell immunity, especially CMV-specific CD4+ cells, 26 may further help in risk stratification and identification of patients who need VGC.…”

Section: Discussionmentioning

confidence: 99%

Low-Dose Valganciclovir Prophylaxis Is Safe and Cost-Saving in CMV-Seropositive Kidney Transplant Recipients

et al. 2021

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Introduction: Observational studies suggest that low-dose valganciclovir prophylaxis (450 mg daily for normal renal function) is as effective as and perhaps safer than standard-dose valganciclovir (900 mg daily) in preventing CMV infection among kidney transplant recipients. However, this practice is not supported by current guidelines due to concerns for breakthrough infection from resistant CMV, mainly in high-risk CMV donor-seropositive/recipient-seronegative kidney transplant recipients. Standard-dose valganciclovir is costly and possibly associated with higher incidence of neutropenia and BKV DNAemia. Our institution adopted low-dose valganciclovir prophylaxis for intermediate-risk (seropositive) kidney transplant recipients in January 2018. Research Question: To analyze the efficacy (CMV DNAemia), safety (BK virus DNAemia, neutropenia, graft loss, and death), and cost savings associated with this change. Design: We retrospectively compared the above outcomes between CMV-seropositive kidney transplant recipients who received low-dose and standard-dose valganciclovir, transplanted within our institution, between 1/19/2014 and 7/15/2019, using propensity score-adjusted competing risk analyses. We also compared cost estimates between the two dosing regimens, for 3 months of prophylaxis, and for different percentage of patient-weeks with normal renal function, using the current average wholesale price of valganciclovir. Results: We studied 179 CMV-seropositive kidney transplant recipients, of whom 55 received low-dose and 124 standard-dose valganciclovir. The majority received nonlymphocyte depleting induction (basiliximab). Low-dose valganciclovir was at least as effective and safe as, and more cost-saving than standard-dose valganciclovir. Conclusion: This single-center study contributes to mounting evidence for future guidelines to be adjusted in favor of low-dose valganciclovir prophylaxis in CMV-seropositive kidney transplant recipients.

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Section: Discussionmentioning

confidence: 99%

Low-Dose Valganciclovir Prophylaxis Is Safe and Cost-Saving in CMV-Seropositive Kidney Transplant Recipients

et al. 2021

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“…Stigma is associated with health consequences for individuals and can also lead to social inequality in health (57). This means, that negative feelings, related to receiving the GDM diagnosis and fear of future health, experienced by some women (58) could be amplified and recurred again when receiving the reminder.…”

Section: Ethical Considerations In Disease Prevention and Screeningmentioning

confidence: 99%

Early Detection of Type 2 Diabetes among Women with Previous Gestational Diabetes Mellitus: Development and Pilottest of an Intervention to Aid Women's Decision on Participation in Follow-Up Screening

Nielsen¹

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Using a commercially available assay that measures cytomegalovirus (CMV)-specific T-cell immunity to predict protection against CMV: A prospective, blinded clinical study

Almaghlouth,

Arvanitis,

Vieira

et al. 2024

Diagnostic Microbiology and Infectious Disease

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CMV cell–mediated immunity assays: Focus on CD4+ cells

Abstract: Laboratory tests to assess cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI), such as the QuantiFERON ®-CMV assay

Cited by 3 publications

References 5 publications

Low-Dose Valganciclovir Prophylaxis Is Safe and Cost-Saving in CMV-Seropositive Kidney Transplant Recipients

Low-Dose Valganciclovir Prophylaxis Is Safe and Cost-Saving in CMV-Seropositive Kidney Transplant Recipients

Early Detection of Type 2 Diabetes among Women with Previous Gestational Diabetes Mellitus: Development and Pilottest of an Intervention to Aid Women's Decision on Participation in Follow-Up Screening

Using a commercially available assay that measures cytomegalovirus (CMV)-specific T-cell immunity to predict protection against CMV: A prospective, blinded clinical study

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