Dynamics and Clinical Significance of Cytomegalovirus-Specific Neutralizing Antibodies in Kidney Transplant Recipients Treated with T-Cell-Depleting Agents

We measured cytomegalovirus (CMV)-specific antibodies that neutralize epithelial cell infection (CMV-AbNEIs) in 101 CMV-seropositive kidney transplant recipients (KTRs) at baseline and posttransplant months 3 and 6. All the patients received antithymocyte globulin and 3-month valganciclovir prophylaxis. There were no significant differences in pretransplant AbNEIs titers between KTRs that developed or did not develop any-level CMV infection or the composite of high-level infection and/or disease. One-year CMV infection-free survival was comparable between KTRs with or without pretransplant CMV-AbNEIs. No differences were observed by months 3 and 6. We observed no protective role for CMV-AbNEIs among CMV-seropositive KTRs undergoing T-cell-depleting induction. No apparent protective role was found for CMV-specific antibodies that neutralize epithelial cell infection measured by microneutralization assay in a single-center cohort of CMV-seropositive kidney transplant recipients that had received T-cell-depleting therapy and a 3-month course of antiviral prophylaxis.