Comparative analysis of human cytomegalovirus-specific CD4(+) T-cell frequency and lymphoproliferative response in human immunodeficiency virus-positive patients

Evaluation of human cytomegalovirus (HCMV)-specific T-helper immunity could contribute in optimizing anti-HCMV therapy in human immunodeficiency virus (HIV)-infected patients. Testin the lymphoproliferative response (LPR) is the standard technique used to evaluate T-helper response, but its use in t he routine diagnostic laboratory setting can be problematic. The most promi sing new alternative technique is the determination of HCMV-specific CD4(+) T-cell frequency by flow cytometry detection of intracellular cytokine pro duction after short-term antigen-specific activation of peripheral blood mo nonuclear cells. HCMV-specific LPR and CD4(+) T-cell frequency were compare d in a group of 78 blood samples from 65 HIV-infected patients. The results showed concordance in 80.7% of samples. In addition, comparative analysis of sequential blood samples from 13 HIV-infected patients showed that while in about half of patients the T-helper HCMV-specific immune response remai ned stable during highly active antiretroviral therapy (HAART), in the othe r half declining levels of the HCMV-specific CD4(+)-mediated immune respons e were:determined by either one or both assays. In conclusion, our data sug gest that the determination of HCMV-specific CD4(+) T-cell frequency can be considered a valuable alternative to the LPR test for the detection of HCM V-specific T-helper response in HIV-infected patients. It could facilitate wider screening of anti-HCMV T-helper activity in HIV-infected patients, wi th potential benefits for clinicians in deciding strategies of discontinuat ion or maintenance of anti-HCMV therapy.