HUMAN CYTOMEGALOVIRUS-INFECTION IS NOT INCREASED IN COMMON VARIABLE IMMUNODEFICIENCY

It has been postulated that human cytomegalovirus (HCMV) infection may have a role in the pathogenesis of common variable immunodeficiency ( CVID). Many patients have a lymphocyte phenotype similar to that seen in HCMV infection, HCMV mononucleosis may precipitate hypogammaglobuli naemia, and a previous small study of common variable immunodeficient patients reported a high rate of active HCMV infection. This study inv estigated the presence and activity of HCMV infection in 102 CVID pati ents. Buffy coats were examined for the presence of HCMV IE and glycop rotein B genes using highly sensitive nested PCR. 30 blood donors of k nown HCMV serologic status were used as controls. There was no signifi cant difference in HCMV positivity by PCR between patients and control s. Enrichment for mononuclear cells prior to PCR had no effect on sens itivity. Twenty-five patients were also examined for HCMV antigenaemia by staining buffy coat cytospins with monoclonal antibodies directed against the HCMV pp65 lower matrix protein, a technique widely used fo r diagnosis of active HCMV disease. Only one patient was positive (and also positive by PCR). Whilst these results do not exclude prior infe ction contributing to antibody deficiency in a small proportion of CVI D patients, this study refutes the previously reported increase in act ive HCMV infection in CVID.