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

Summary 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.