Anti-cytomegalovirus IgG antibody titer is positively associated with advanced T cell differentiation and coronary artery disease in end-stage renal disease.

Background: Accumulating evidence indicates that persistent human cytomegalovirus (HCMV) infection is associated with several health-related adverse outcomes including atherosclerosis and premature mortality in individuals with normal renal function. Patients with end-stage renal disease (ESRD) exhibit impaired immune function and thus may face higher risk of HCMV-related adverse outcomes. Whether the level of anti-HCMV immune response may be associated with the prognosis of hemodialysis patients is unknown.
Results: Among 412 of the immunity in ESRD study (iESRD study) participants, 408 were HCMV seropositive and were analyzed. Compared to 57 healthy individuals, ESRD patients had higher levels of anti-HCMV IgG. In a multivariate-adjusted logistic regression model, the log level of anti-HCMV IgG was independently associated with prevalent coronary artery disease (OR = 1.93, 95% CI = 1.2~ 3.2, p  = 0.01) after adjusting for age, sex, hemoglobin, diabetes, calcium phosphate product and high sensitivity C-reactive protein. Levels of anti-HCMV IgG also positively correlated with both the percentage and absolute number of terminally differentiated CD8+ and CD4+ CD45RA+ CCR7- T _EMRA cells, indicating that immunosenescence may participate in the development of coronary artery disease.
Conclusion: This is the first study showing that the magnitude of anti-HCMV humoral immune response positively correlates with T cell immunosenescence and coronary artery disease in ESRD patients. The impact of persistent HCMV infection should be further investigated in this special patient population.
Competing Interests: The study is approved by both FEMH and NTUH’s institutional ethical committees (FEMH 103084-E and NTUYL 201511092 RINA) and informed consent was acquired from all participants.All authors consent to the publication of this final version of manuscript.Non-declared. The authors declare that the research was conducted in the absence of any commercial or financial relationships that serves as a potential conflict of interest. The results presented in this paper have not been published previously in whole or part, except in abstract format.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.