Korean J Transplant.  2022 Nov;36(Supple 1):S75. 10.4285/ATW2022.F-1921.

Analysis of HLA types with cytomegalovirus-specific cell mediated immunity in seropositive kidney transplant candidates

• Lee H
• Kang H
• Yun S
• Ryu JH
• Bae H
• Lee J
• Ko GY
• Oh EJ

• KMID: 2535591
• DOI: http://doi.org/10.4285/ATW2022.F-1921

Abstract

Background
Cytomegalovirus (CMV)-specific cell-mediated immunity (CMV-CMI) is variable in CMV-seropositive (R+) individuals and has been defined as a predictive biomarker of CMV infection after kidney transplantation (KT). We analyzed whether HLA A, B, C, DR types are associated with CMV-CMI response in R+ KT candidates.
Methods
A total of 229 CMV transplant candidates were included. The CMV-CMI was measured by enzyme-linked immunospot (ELISPOT) assays against pp65 and IE-1 antigens.
Results
In KT candidates, pp65-and IE-1-ELISPOT results were (277.5 [233.6–325.8]) and (41.0 [27.2-59.8]) (median [95% confidence interval]) spots per 200,000 lymphocytes. Candidates with HLA-A2 (+) or HLA-A30 (–) had increased CMV-CMI than those with HLA-A2 (–) or HLA-A30 (+), respectively (P=0.025 and 0.042, respectively). HLA-B7 or HLA-B58 was associated with an increase in IE-1 CMV-CMI (P=0.027 and 0.032, respectively). We divided the patients into four groups according to pp65-and IE-1-ELISPOT results (pp65-ELISPOT: <115, 115–276, 277–470, >471; IE-1-ELISPOT: <9, 9–40, 41–184, >185 spots per 200,000 lym-phocytes). Candidates with HLA-A2, -B7, -B54, or -Cw1 tended to be included in the group with higher ELISPOT results. When we analyze the association between Korean HLA haplotypes and CMV-CMI results, candidates with HLA-A2/B27/Cw1/DR1 had the highest pp65-ELISPOT results (456 [244.9–59.3]), and those with HLA-A30/B13/Cw6/DR7 had lowest results (105.5 [18.2–264.6], P=0.017). For IE-1-ELISPOT, A2/B54/Cw1/DR15 haplotype and A30/B13/Cw6/DR7 haplotype had highest and lowest results, re-spectively (372.3 [56.1–808.1] vs. 10.8 [4.7–94.5], P=0.028]).
Conclusions
We observed the differences in CMV-CMI according to the HLA types and HLA haplotypes. HLA types may help stratify the risk of CMV infection associated with CMV-CMIs in CMV-seropositive KT candidates.