The T cell response to persistent herpes virus infections in common variable immunodeficiency


Dr Anthony David Webster, Centre for Immunology, Hampstead Campus, Royal Free and University College Medical School, Pond Street, London NW3 2QG, UK. E-mail:


We show that at least half of patients with common variable immunodeficiency (CVID) have circulating CD8+ T cells specific for epitopes derived from cytomegalovirus (CMV) and/or the Epstein–Barr virus (EBV). Compared to healthy age-matched subjects, more CD8+ T cells in CVID patients were committed to CMV. Despite previous reports of defects in antigen presentation and cellular immunity in CVID, specific CD4+ and CD8+ T cells produced interferon (IFN)-γ after stimulation with CMV peptides, and peripheral blood mononuclear cells secreted perforin in response to these antigens. In CVID patients we found an association between a high percentage of circulating CD8+ CD57+ T cells containing perforin, CMV infection and a low CD4/CD8 ratio, suggesting that CMV may have a major role in the T cell abnormalities described previously in this disease. We also show preliminary evidence that CMV contributes to the previously unexplained severe enteropathy that occurs in about 5% of patients.