T-lymphocyte subsets in lung transplant recipients: association between nadir CD4 T-cell count and viral infections after transplantation.

Abstract

BACKGROUND:

Little is known about the kinetics of T-cell subsets in lung transplant recipients (LTR) and their association with the occurrence of opportunistic infections (OI).

OBJECTIVES:

To analyze the kinetics of T-lymphocyte subsets in LTR and the association between nadir CD4 T-cell count and viral infections after transplantation.

STUDY DESIGN:

Serial measurements of peripheral blood CD4 and CD8 T-cell counts obtained during the first year post-transplantation from 83 consecutive LTR and their correlation with both viral OI and community-acquired infections post-transplantation were retrospectively analyzed.

RESULTS:

LTR with a nadir CD4 T-cell count <200 cells/μl had consistently lower CD4 and CD8 T-cell counts than LTR with a nadir CD4 T-cell count >200 cells/μl (p<0.001). In LTR with a nadir CD4 T-cell count <200 cells/μl, the cumulative incidence of viral infections detected in peripheral blood and in bronchoalveolar lavage (BAL) samples was higher than in LTR with a nadir CD4 T-cell count >200 cells/μl (p=0.0012 and p=0.0058, respectively). A nadir CD4 T-cell count <200 cells/μl within the first three months post-transplantation predicted a higher frequency of viral infectious episodes in BAL samples within the subsequent six month period (p=0.0066).

CONCLUSIONS:

Stratification of patients according to nadir CD4 T-cell count may represent a new and simple approach for early identification of patients at risk for subsequent virus infections.

• Authors: Sandra A Calarota, Antonella Chiesa, Annalisa De Silvestri, Monica Morosini, Tiberio Oggionni, Piero Marone, Federica Meloni, Fausto Baldanti
• Journal: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology (J Clin Virol) Vol. 69 Pg. 110-6 (Aug 2015) ISSN: 1873-5967 [Electronic] Netherlands
• PMID: 26209391 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Elsevier B.V. All rights reserved.

Topics

• Adult
• Bronchoalveolar Lavage Fluid (immunology, virology)
• CD4 Lymphocyte Count
• CD4-Positive T-Lymphocytes (metabolism)
• CD8-Positive T-Lymphocytes (metabolism)
• Community-Acquired Infections (blood, epidemiology, immunology, virology)
• Female
• Humans
• Incidence
• Lung Transplantation (adverse effects)
• Lymphocyte Count
• Male
• Middle Aged
• Opportunistic Infections (blood, epidemiology, immunology, virology)
• Predictive Value of Tests
• T-Lymphocyte Subsets (metabolism)