Hemodialysis Clinical Trial
Official title:
Quantification de l'immunité T Anti-CMV à l'Aide d'un Test IGRA Chez Des Patients greffés rénaux et Des Patients dialysés, Comparaison Avec Une Population de témoins
Evaluation of anti-CMV T cellular immunity using an IGRA test (Quantiferon-CMV test) in kidney transplant recipients and hemodialysis patients, comparison to control patients.
Cytomegalovirus (CMV) infection is a common opportunistic complication after kidney
transplantation (KT). It has been associated with high morbidity and mortality in kidney
transplant recipients (KTR). Its actual management is only based on the humoral immunity :
the main risk factor for CMV infection after KT is the association of a seropositive donor
and a seronegative recipient (so-called "D+/R- mismatch").
However several studies have highlighted the essential role of cellular immunity to control
CMV infection. The Quantiferon-CMV (QF-CMV) is an IGRA test (Interferon Gamma Releasing
Assay) which evaluates T CD8 lymphocytes production of Interferon Gamma (IFNy) exposed to CMV
antigens. Some studies have shown the possible interest of the QF-CMV in predicting CMV
infection after antiviral prophylaxis discontinuation or when CMV viremia is detected.
However some limits have been underlined. First its positivity threshold hasn't been approved
in KTR. Hemodialysis patients (HP) called to receive a renal allograft also suffered from
altered immunity. No study has directly compared the QF-CMV value in KTR, HP and control
patients.
That's why we propose evaluating the expression of basal cellular immunity against CMV (far
from any active infection) in KTR and HP using the QF-CMV and comparing it to control
patients population (not suffering from kidney dysfunction or immunosuppression).
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