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Disease Markers
Volume 2014, Article ID 947432, 8 pages
Clinical Study

The Use of Humoral Responses as a Marker of CMV Burden in HIV Patients on ART Requires Consideration of T-Cell Recovery and Persistent B-Cell Activation

1School of Pathology and Laboratory Medicine, University of WA, Nedlands, WA 6009, Australia
2Microbiology and Infectious Diseases, Royal Perth Hospital, Perth, WA 6000, Australia
3Clinical Immunology and Immunogenetics, Royal Perth Hospital, Perth, WA 6000, Australia
4Immunology & Immunopathology, PathWest Laboratory Medicine, Nedlands, WA 6009, Australia
5Medicine and Pharmacology, University of WA, Nedlands, WA 6009, Australia

Received 12 September 2014; Accepted 30 October 2014; Published 23 November 2014

Academic Editor: Giuseppe Murdaca

Copyright © 2014 Samantha J. Brunt et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. Elevated humoral responses to cytomegalovirus (CMV) associate with increased risk of cardiovascular disease (CVD) in HIV patients on antiretroviral therapy (ART). To better understand the persistence of CMV humoral responses in relation to CVD, we determined trends in CMV antibody levels over the first 10 years on ART. Design. We describe longitudinal analyses of plasma from 13 HIV patients commencing ART with <210 CD4 T-cells/µL and 27 controls. Antibodies reactive with CMV (fibroblast lysate, gB and IE-1 antigens), EBV-VCA, and HIVgp41 were quantitated. B-cell activation was assessed via total IgG and sBAFF. Inflammation was assessed via sTNF-RI and sCD14. Results. Amongst CMV seropositive HIV patients, levels of antibody reactive with CMV and EBV-VCA peaked after 1 year on ART. Levels of total IgG, sCD14, and sTNF-RI declined to approximate those in controls after 10 years, but sBAFF , EBV-VCA , and CMV antibodies remained elevated. A strong correlation between sBAFF and CMVgB antibody was seen at 10 years and verified in a second cohort. Conclusions. CMV antibody titres peak on ART and remain high. A correlation between CMV antibody and sBAFF suggests a role for HIV-induced B-cell pathology that may affect its use as a marker of CMV burden.