A Prospective Assessment of Cytomegalovirus Immune Evasion Gene Transcription Profiles in Transplant Patients With Cytomegalovirus Infection
Bibliographic record
Abstract
BACKGROUND: The cytomegalovirus (CMV) immune evasion genes US3, US6, and US11 may disrupt the host immune response via downregulation of major histocompatibility complex molecules. Transplant recipients with CMV infection were prospectively assessed for immune evasion gene expression. METHODS: Seventy solid organ transplant patients with CMV infection who were given antiviral therapy were enrolled. Quantitative mRNA levels of US3, US6, and US11 were assessed using real-time polymerase chain reaction assays from peripheral blood mononuclear cells at regular time-points after starting therapy. RESULTS: High immune evasion mRNA levels were detectable at start-of-therapy (median US3-4.5 log10 copies; US6- 3.7 log10 copies, and US11-3.3 log10 copies/10 cells). With therapy, immune evasion mRNA levels declined exponentially. For example, median calculated US3 half-life was 1.59 days (range 0.74-12.5 days). By day7, US3 mRNA was detectable in 55.7%, US6 in 38.6%, and US11 in 41.4% of patients. Early phase kinetics correlated with outcomes. When adjusted for baseline DNA level, there was a trend to higher mRNA levels in patients who relapsed. Also, detectable mRNA at day 14 after start of therapy was associated with virologic relapse after initial treatment (P<or=0.001 for US3, US6, and US11). For example, if US3 mRNA was still detectable at day 14, then risk of relapse was 84.2% vs. 29.4% if US3 mRNA not detectable at day 14 (P<0.001). This correlation was independent of the DNA viral load. CONCLUSION: CMV immune evasion gene expression is detectable at high levels in patients with CMV infection and declines exponentially with therapy. Expression levels can be independently correlated with outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".