Primary cytomegalovirus infection significantly impacts circulating T cells in kidney transplant recipients

Cytomegalovirus (CMV) infection profoundly affects the T cell compartment and is associated with alterations in T cell aging parameters and generation of cytotoxic CD4+CD28null T cells. Hence, the effect of a primary CMV infection post-kidney transplantation (KT) on the peripheral T cell compartment was examined. As aging parameters, we determined the T cell differentiation status, T cell receptor excision circle (TREC) content, CD31+ naïve T cell numbers and relative telomere length (RTL) pre-KT and 12 months post-KT. CMV-seronegative KT recipients, receiving a kidney from a CMV-seropositive donor (D+/R-) were compared to D+/R+ KT recipients. Eleven out of the 22 D+/R- KT recipients had CMV viremia post-KT. They developed CMV-specific CD4+ and CD8+ T cells and their T cell compartment shifted towards a more differentiated memory phenotype with expansion of CD4+CD28null and CD8+CD28null cells. One year post-KT, the CD8+ T cell count was almost doubled compared to nonviremic D+/R- and D+/R+ KT recipients. In addition, the RTL of the CD8+ T cell was significantly lower and both the TREC content and CD31+ naïve T cell numbers significantly decreased. Moreover, primary CMV infection was associated with a negative impact on glomerular filtration rate. In conclusion, primary CMV infection has a substantial impact on the number and phenotype of peripheral T cells and may negatively affect renal allograft function. In this study, the authors examine the effect of a primary cytomegalovirus infection on peripheral T cells after kidney transplantation and find that a primary cytomegalovirus infection substantially impacts the number and phenotype of circulating T cells and may negatively affect allograft function.

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