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International Immunology Advance Access originally published online on May 24, 2004
International Immunology 2004 16(7):983-989; doi:10.1093/intimm/dxh099
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International Immunology, Vol. 16, No. 7, pp. 983-989, July 2004
© 2004 Japanese Society for Immunology

Determining virological, serological and immunological parameters of EBV infection in the development of PTLD

Joanne E. Davis, Martina A. Sherritt, Mandvi Bharadwaj, Leanne E. Morrison, Suzanne L. Elliott, Laurie M. Kear, Joanne Maddicks-Law, Tom Kotsimbos1, Devinder Gill2, Monique Malouf3, Michael C. Falk4, Rajiv Khanna and Denis J. Moss

EBV Biology Laboratory, Division of Immunology and Infectious Diseases and the Cooperative Research Centre for Vaccine Technology, The Queensland Institute of Medical Research and University of Queensland Joint Oncology Program, Brisbane, 4029 Australia 1 Alfred Hospital, Melbourne, Australia 2 The Princess Alexandra Hospital, Brisbane, Australia 3 The St Vincent’s Hospital, Sydney, Australia 4 Canberra Hospital, Canberra, Australia

Correspondence to: J. Davis; E-mail: joanneDa{at}qimr.edu.au
Transmitting editor: D. Tarlinton

Post-transplant lymphoproliferative disease (PTLD) in Epstein–Barr virus (EBV) seronegative solid organ transplant recipients remains a significant problem, particularly in the first year post-transplant. Immune monitoring of a cohort of high-risk patients indicated that four EBV seronegative transplant recipients developed early-onset PTLD prior to evidence of an EBV humoral response. EBV status has been classically defined serologically, however these patients demonstrated multiple parameters of EBV infection, including the generation of EBV-specific CTL, outgrowth of spontaneous lymphoblastoid cell lines, and elevated EBV DNA levels, despite the absence of a classic EBV antibody response. As EBV serology is influenced by both immunosuppression and cytomegalovirus immunoglobulin treatment, both the EBV-specific CTL response and elevated EBV levels are more reliable indicators of EBV infection post-transplant.

Keywords: CTL response, Epstein–Barr virus, post-transplant lymphoproliferative disease, serology


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