{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:08:52Z","timestamp":1783037332558,"version":"3.54.6"},"reference-count":87,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T00:00:00Z","timestamp":1624924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>In stark contrast to the rapid development of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an effective human immunodeficiency virus (HIV) vaccine is still lacking. Furthermore, despite virologic suppression and CD4 T-cell count normalization with antiretroviral therapy (ART), people living with HIV (PLWH) still exhibit increased morbidity and mortality compared to the general population. Such differences in health outcomes are related to higher risk behaviors, but also to HIV-related immune activation and viral coinfections. Among these coinfections, cytomegalovirus (CMV) latent infection is a well-known inducer of long-term immune dysregulation. Cytomegalovirus contributes to the persistent immune activation in PLWH receiving ART by directly skewing immune response toward itself, and by increasing immune activation through modification of the gut microbiota and microbial translocation. In addition, through induction of immunosenescence, CMV has been associated with a decreased response to infections and vaccines. This review provides a comprehensive overview of the influence of CMV on the immune system, the mechanisms underlying a reduced response to vaccines, and discuss new therapeutic advances targeting CMV that could be used to improve vaccine response in PLWH.<\/jats:p>","DOI":"10.3390\/v13071266","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T22:39:43Z","timestamp":1625006383000},"page":"1266","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Cytomegalovirus as an Uninvited Guest in the Response to Vaccines in People Living with HIV"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2367-7682","authenticated-orcid":false,"given":"L\u00e9na","family":"Royston","sequence":"first","affiliation":[{"name":"Infectious Diseases and Immunity in Global Health Program, Research Institute, McGill University Health Centre, Montr\u00e9al, QC H4A 3J1, Canada"},{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montr\u00e9al, QC H4A 3J1, Canada"},{"name":"Canadian Institutes of Health Research, Canadian HIV Trials Network, Vancouver, BC V6Z 1Y6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6249-1659","authenticated-orcid":false,"given":"St\u00e9phane","family":"Isnard","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Immunity in Global Health Program, Research Institute, McGill University Health Centre, Montr\u00e9al, QC H4A 3J1, Canada"},{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montr\u00e9al, QC H4A 3J1, Canada"},{"name":"Canadian Institutes of Health Research, Canadian HIV Trials Network, Vancouver, BC V6Z 1Y6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lin","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Immunity in Global Health Program, Research Institute, McGill University Health Centre, Montr\u00e9al, QC H4A 3J1, Canada"},{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montr\u00e9al, QC H4A 3J1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9897-7589","authenticated-orcid":false,"given":"Jean-Pierre","family":"Routy","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Immunity in Global Health Program, Research Institute, McGill University Health Centre, Montr\u00e9al, QC H4A 3J1, Canada"},{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montr\u00e9al, QC H4A 3J1, Canada"},{"name":"Division of Hematology, McGill University Health Centre, Montr\u00e9al, QC H4A 3J1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S0140-6736(18)31311-4","article-title":"HIV","volume":"392","author":"Ghosn","year":"2018","journal-title":"Lancet"},{"key":"ref_2","unstructured":"(2021, March 07). AIDSinfo | UNAIDS. Available online: https:\/\/aidsinfo.unaids.org\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1128\/JVI.79.2.1154-1163.2005","article-title":"Antigenicity and Immunogenicity of a Synthetic Human Immunodeficiency Virus Type 1 Group m Consensus Envelope Glycoprotein","volume":"79","author":"Gao","year":"2005","journal-title":"J. Virol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1056\/NEJMoa0908492","article-title":"Vaccination with ALVAC and AIDSVAX to Prevent HIV-1 Infection in Thailand","volume":"361","author":"Pitisuttithum","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1056\/NEJMoa2031499","article-title":"Vaccine Efficacy of ALVAC-HIV and Bivalent Subtype C Gp120-MF59 in Adults","volume":"384","author":"Gray","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.immuni.2018.11.011","article-title":"Vaccine-Induced Protection from Homologous Tier 2 SHIV Challenge in Nonhuman Primates Depends on Serum-Neutralizing Antibody Titers","volume":"50","author":"Pauthner","year":"2019","journal-title":"Immunity"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1038\/s41577-018-0103-6","article-title":"Advancing an HIV Vaccine; Advancing Vaccinology","volume":"19","author":"Burton","year":"2019","journal-title":"Nat. Rev. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1093\/infdis\/jiu840","article-title":"HIV Infection Worsens Age-Associated Defects in Antibody Responses to Influenza Vaccine","volume":"211","author":"George","year":"2015","journal-title":"J. Infect Dis."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Cram, J.A., Fiore-Gartland, A.J., Srinivasan, S., Karuna, S., Pantaleo, G., Tomaras, G.D., Fredricks, D.N., and Kublin, J.G. (2019). Human Gut Microbiota Is Associated with HIV-Reactive Immunoglobulin at Baseline and Following HIV Vaccination. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0225622"},{"key":"ref_10","unstructured":"(2021, June 15). Virus Taxonomy: 2020 Release. Available online: https:\/\/talk.ictvonline.org\/taxonomy\/."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1002\/rmv.655","article-title":"Review of Cytomegalovirus Seroprevalence and Demographic Characteristics Associated with Infection","volume":"20","author":"Cannon","year":"2010","journal-title":"Rev. Med. Virol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e2034","DOI":"10.1002\/rmv.2034","article-title":"Estimation of the Worldwide Seroprevalence of Cytomegalovirus: A Systematic Review and Meta-Analysis","volume":"29","author":"Zuhair","year":"2019","journal-title":"Rev. Med. Virol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"368","DOI":"10.3389\/fcimb.2020.00368","article-title":"The Differentiation of Human Cytomegalovirus Infected-Monocytes Is Required for Viral Replication","volume":"10","author":"Min","year":"2020","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Maidji, E., Somsouk, M., Rivera, J.M., Hunt, P.W., and Stoddart, C.A. (2017). Replication of CMV in the Gut of HIV-Infected Individuals and Epithelial Barrier Dysfunction. PLoS Pathog., 13.","DOI":"10.1371\/journal.ppat.1006202"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1084\/jem.20160758","article-title":"Tissue Reservoirs of Antiviral T Cell Immunity in Persistent Human CMV Infection","volume":"214","author":"Gordon","year":"2017","journal-title":"J. Exp. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1093\/infdis\/jiy493","article-title":"Subclinical Reactivation of Cytomegalovirus Drives CD4+CD28null T-Cell Expansion and Impaired Immune Response to Pneumococcal Vaccination in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis","volume":"219","author":"Chanouzas","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ramendra, R., Isnard, S., Lin, J., Fombuena, B., Ouyang, J., Mehraj, V., Zhang, Y., Finkelman, M., Costiniuk, C., and Lebouch\u00e9, B. (2019). CMV Seropositivity Is Associated with Increased Microbial Translocation in People Living with HIV and Uninfected Controls. Clin. Infect. Dis.","DOI":"10.1093\/cid\/ciz1001"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1111\/imm.12855","article-title":"Association between \u03b3 Marker, Human Leucocyte Antigens and Killer Immunoglobulin-like Receptors and the Natural Course of Human Cytomegalovirus Infection: A Pilot Study Performed in a Sicilian Population","volume":"153","author":"Accardi","year":"2018","journal-title":"Immunology"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Aiello, A., Accardi, G., Candore, G., Caruso, C., Colomba, C., Di Bona, D., Duro, G., Gambino, C.M., Ligotti, M.E., and Pandey, J.P. (2019). Role of Immunogenetics in the Outcome of HCMV Infection: Implications for Ageing. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20030685"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.cell.2014.12.020","article-title":"Variation in the Human Immune System Is Largely Driven by Non-Heritable Influences","volume":"160","author":"Brodin","year":"2015","journal-title":"Cell"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1093\/infdis\/jiu093","article-title":"Heterogeneity of CD4+ and CD8+ T-Cell Responses to Cytomegalovirus in HIV-Infected and HIV-Uninfected Men Who Have Sex with Men","volume":"210","author":"Li","year":"2014","journal-title":"J. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1084\/jem.20050882","article-title":"Broadly Targeted Human Cytomegalovirus-Specific CD4+ and CD8+ T Cells Dominate the Memory Compartments of Exposed Subjects","volume":"202","author":"Sylwester","year":"2005","journal-title":"J. Exp. Med."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bellon, M., and Nicot, C. (2017). Telomere Dynamics in Immune Senescence and Exhaustion Triggered by Chronic Viral Infection. Viruses, 9.","DOI":"10.3390\/v9100289"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.bbi.2011.11.007","article-title":"Inflammation and Reactivation of Latent Herpesviruses in Older Adults","volume":"26","author":"Bennett","year":"2012","journal-title":"Brain Behav. Immun."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Gianella, S., Moser, C., Vitomirov, A., McKhann, A., Layman, L., Scott, B., Caballero, G., Lada, S., Bosch, R.J., and Hoenigl, M. (2020). Presence of Asymptomatic CMV and EBV DNA in Blood of Persons with HIV Starting Antiretroviral Therapy Are Associated with Non-AIDS Clinical Events. AIDS.","DOI":"10.1097\/QAD.0000000000002484"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Neurath, M.F., \u00dcberla, K., and Ng, S.C. (2021). Gut as Viral Reservoir: Lessons from Gut Viromes, HIV and COVID-19. Gut.","DOI":"10.1136\/gutjnl-2021-324622"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1002\/(SICI)1521-4141(199904)29:04<1202::AID-IMMU1202>3.0.CO;2-O","article-title":"Human Intestinal Lamina Propria Lymphocytes Are Naturally Permissive to HIV-1 Infection","volume":"29","author":"Lapenta","year":"1999","journal-title":"Eur. J. Immunol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1038\/nm1511","article-title":"Microbial Translocation Is a Cause of Systemic Immune Activation in Chronic HIV Infection","volume":"12","author":"Brenchley","year":"2006","journal-title":"Nat. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"ofaa338","DOI":"10.1093\/ofid\/ofaa338","article-title":"Repurposing Metformin in Nondiabetic People With HIV: Influence on Weight and Gut Microbiota","volume":"7","author":"Isnard","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"639291","DOI":"10.3389\/fimmu.2021.639291","article-title":"Long-Term Suppressive CART Is Not Sufficient to Restore Intestinal Permeability and Gut Microbiota Compositional Changes","volume":"12","author":"Ancona","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Serrano-Villar, S., Sainz, T., Lee, S.A., Hunt, P.W., Sinclair, E., Shacklett, B.L., Ferre, A.L., Hayes, T.L., Somsouk, M., and Hsue, P.Y. (2014). HIV-Infected Individuals with Low CD4\/CD8 Ratio despite Effective Antiretroviral Therapy Exhibit Altered T Cell Subsets, Heightened CD8+ T Cell Activation, and Increased Risk of Non-AIDS Morbidity and Mortality. PLoS Pathog., 10.","DOI":"10.1371\/journal.ppat.1004078"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1073\/pnas.1318249111","article-title":"Persistent HIV-1 Replication Is Associated with Lower Antiretroviral Drug Concentrations in Lymphatic Tissues","volume":"111","author":"Fletcher","year":"2014","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1097\/QAD.0000000000001579","article-title":"Effect of Cytomegalovirus and Epstein-Barr Virus Replication on Intestinal Mucosal Gene Expression and Microbiome Composition of HIV-Infected and Uninfected Individuals","volume":"31","author":"Gianella","year":"2017","journal-title":"AIDS"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12981-017-0164-9","article-title":"Potential Contribution of Gut Microbiota and Systemic Inflammation on HIV Vaccine Effectiveness and Vaccine Design","volume":"14","author":"Routy","year":"2017","journal-title":"AIDS Res. Ther"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"656414","DOI":"10.3389\/fimmu.2021.656414","article-title":"Gut Leakage of Fungal-Related Products: Turning Up the Heat for HIV Infection","volume":"12","author":"Isnard","year":"2021","journal-title":"Front. Immunol"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1128\/JVI.01449-07","article-title":"Rapid Onset of Intestinal Epithelial Barrier Dysfunction in Primary Human Immunodeficiency Virus Infection Is Driven by an Imbalance between Immune Response and Mucosal Repair and Regeneration","volume":"82","author":"Sankaran","year":"2008","journal-title":"J. Virol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1038\/s41385-018-0032-5","article-title":"Intestinal Damage Precedes Mucosal Immune Dysfunction in SIV Infection","volume":"11","author":"Berard","year":"2018","journal-title":"Mucosal Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Nazli, A., Chan, O., Dobson-Belaire, W.N., Ouellet, M., Tremblay, M.J., Gray-Owen, S.D., Arsenault, A.L., and Kaushic, C. (2010). Exposure to HIV-1 Directly Impairs Mucosal Epithelial Barrier Integrity Allowing Microbial Translocation. PLoS Pathog., 6.","DOI":"10.1371\/journal.ppat.1000852"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Allam, O., Samarani, S., Mehraj, V., Jenabian, M.-A., Tremblay, C., Routy, J.-P., Amre, D., and Ahmad, A. (2018). HIV Induces Production of IL-18 from Intestinal Epithelial Cells That Increases Intestinal Permeability and Microbial Translocation. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0194185"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1080\/19490976.2019.1643674","article-title":"Links between the Gut Microbiota, Metabolism, and Host Behavior","volume":"11","author":"Schretter","year":"2020","journal-title":"Gut Microbes"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"324","DOI":"10.15698\/mic2019.08.685","article-title":"The Influence of the Microbiota on Immune Development, Chronic Inflammation, and Cancer in the Context of Aging","volume":"6","author":"Tibbs","year":"2019","journal-title":"Microb. Cell"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Ouyang, J., Lin, J., Isnard, S., Fombuena, B., Peng, X., Marette, A., Routy, B., Messaoudene, M., Chen, Y., and Routy, J.-P. (2020). The Bacterium Akkermansia Muciniphila: A Sentinel for Gut Permeability and Its Relevance to HIV-Related Inflammation. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.00645"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1038\/nri.2016.42","article-title":"Gut Microbiota, Metabolites and Host Immunity","volume":"16","author":"Rooks","year":"2016","journal-title":"Nat. Rev. Immunol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1038\/s41423-020-00625-0","article-title":"Control of Lymphocyte Functions by Gut Microbiota-Derived Short-Chain Fatty Acids","volume":"18","author":"Kim","year":"2021","journal-title":"Cell. Mol. Immunol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.immuni.2012.04.011","article-title":"Commensal Bacteria Calibrate the Activation Threshold of Innate Antiviral Immunity","volume":"37","author":"Abt","year":"2012","journal-title":"Immunity"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"S58","DOI":"10.1093\/infdis\/jiw258","article-title":"Gut Mucosal Barrier Dysfunction, Microbial Dysbiosis, and Their Role in HIV-1 Disease Progression","volume":"214","author":"Mudd","year":"2016","journal-title":"J. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1038\/mi.2013.116","article-title":"An Altered Intestinal Mucosal Microbiome in HIV-1 Infection Is Associated with Mucosal and Systemic Immune Activation and Endotoxemia","volume":"7","author":"Dillon","year":"2014","journal-title":"Mucosal Immunol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1007\/s11904-019-00441-w","article-title":"HIV and the Gut Microbiota: Composition, Consequences, and Avenues for Amelioration","volume":"16","author":"Somsouk","year":"2019","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1186\/s40168-019-0687-5","article-title":"Evolution of the Gut Microbiome Following Acute HIV-1 Infection","volume":"7","author":"Rocafort","year":"2019","journal-title":"Microbiome"},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Mutlu, E.A., Keshavarzian, A., Losurdo, J., Swanson, G., Siewe, B., Forsyth, C., French, A., DeMarais, P., Sun, Y., and Koenig, L. (2014). A Compositional Look at the Human Gastrointestinal Microbiome and Immune Activation Parameters in HIV Infected Subjects. PLoS Pathog., 10.","DOI":"10.1371\/journal.ppat.1003829"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Santos Rocha, C., Hirao, L.A., Weber, M.G., M\u00e9ndez-Lagares, G., Chang, W.L.W., Jiang, G., Deere, J.D., Sparger, E.E., Roberts, J., and Barry, P.A. (2018). Subclinical Cytomegalovirus Infection Is Associated with Altered Host Immunity, Gut Microbiota, and Vaccine Responses. J. Virol., 92.","DOI":"10.1128\/JVI.00167-18"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s10719-005-0326-1","article-title":"Activation of CMV Promoter-Controlled Glycosyltransferase and Beta -Galactosidase Glycogenes by Butyrate, Tricostatin A, and 5-Aza-2\u2019-Deoxycytidine","volume":"22","author":"Choi","year":"2005","journal-title":"Glycoconj. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/j.jaci.2020.03.017","article-title":"Influence of Immune Aging on Vaccine Responses","volume":"145","author":"Gustafson","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1016\/j.vaccine.2005.08.105","article-title":"Antibody Response to Influenza Vaccination in the Elderly: A Quantitative Review","volume":"24","author":"Goodwin","year":"2006","journal-title":"Vaccine"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1038\/nri2508","article-title":"B-Cell Responses to Vaccination at the Extremes of Age","volume":"9","author":"Siegrist","year":"2009","journal-title":"Nat. Rev. Immunol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/j.1365-2567.2004.02006.x","article-title":"Age-Related Loss of Na\u00efve T Cells and Dysregulation of T-Cell\/B-Cell Interactions in Human Lymph Nodes","volume":"114","author":"Lazuardi","year":"2005","journal-title":"Immunology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2689","DOI":"10.4049\/jimmunol.1302064","article-title":"Age-Related Decrease in TCR Repertoire Diversity Measured with Deep and Normalized Sequence Profiling","volume":"192","author":"Britanova","year":"2014","journal-title":"J. Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Cicin-Sain, L., Brien, J.D., Uhrlaub, J.L., Drabig, A., Marandu, T.F., and Nikolich-Zugich, J. (2012). Cytomegalovirus Infection Impairs Immune Responses and Accentuates T-Cell Pool Changes Observed in Mice with Aging. PLoS Pathog., 8.","DOI":"10.1371\/journal.ppat.1002849"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"476","DOI":"10.4049\/jimmunol.1800217","article-title":"Cytomegalovirus Exposure in the Elderly Does Not Reduce CD8 T Cell Repertoire Diversity","volume":"202","author":"Lindau","year":"2019","journal-title":"J. Immunol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s11357-019-00068-0","article-title":"Do Cytomegalovirus-Specific Memory T Cells Interfere with New Immune Responses in Lymphoid Tissues?","volume":"41","author":"Uhrlaub","year":"2019","journal-title":"Geroscience"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.chom.2016.04.003","article-title":"Sequential Infection with Common Pathogens Promotes Human-like Immune Gene Expression and Altered Vaccine Response","volume":"19","author":"Reese","year":"2016","journal-title":"Cell Host Microbe"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"7481","DOI":"10.4049\/jimmunol.173.12.7481","article-title":"Herpesvirus-Specific CD8 T Cell Immunity in Old Age: Cytomegalovirus Impairs the Response to a Coresident EBV Infection","volume":"173","author":"Khan","year":"2004","journal-title":"J. Immunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"3624","DOI":"10.4049\/jimmunol.1303361","article-title":"Latent Infection with Cytomegalovirus Is Associated with Poor Memory CD4 Responses to Influenza A Core Proteins in the Elderly","volume":"193","author":"Derhovanessian","year":"2014","journal-title":"J. Immunol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e2144","DOI":"10.1002\/rmv.2144","article-title":"Why the Elderly Appear to Be More Severely Affected by COVID-19: The Potential Role of Immunosenescence and CMV","volume":"30","author":"Kadambari","year":"2020","journal-title":"Rev. Med. Virol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12979-021-00218-z","article-title":"Does Reactivation of Cytomegalovirus Contribute to Severe COVID-19 Disease?","volume":"18","year":"2021","journal-title":"Immun. Ageing"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"3826","DOI":"10.1016\/S0264-410X(03)00309-8","article-title":"Association between Cytomegalovirus Infection, Enhanced Proinflammatory Response and Low Level of Anti-Hemagglutinins during the Anti-Influenza Vaccination\u2014An Impact of Immunosenescence","volume":"21","author":"Trzonkowski","year":"2003","journal-title":"Vaccine"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1002\/jmv.23642","article-title":"Impact of Human Cytomegalovirus (CMV) Infection on Immune Response to Pandemic 2009 H1N1 Influenza Vaccine in Healthy Adults","volume":"85","author":"Wald","year":"2013","journal-title":"J. Med. Virol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00430-019-00602-z","article-title":"Effect of Latent Cytomegalovirus Infection on the Antibody Response to Influenza Vaccination: A Systematic Review and Meta-Analysis","volume":"208","author":"Warmink","year":"2019","journal-title":"Med. Microbiol. Immunol."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Bowyer, G., Sharpe, H., Venkatraman, N., Ndiaye, P.B., Wade, D., Brenner, N., Mentzer, A., Mair, C., Waterboer, T., and Lambe, T. (2020). Reduced Ebola Vaccine Responses in CMV+ Young Adults Is Associated with Expansion of CD57+KLRG1+ T Cells. J. Exp. Med., 217.","DOI":"10.1084\/jem.20200004"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"e294","DOI":"10.1016\/S2352-3018(21)00070-9","article-title":"Overview of SARS-CoV-2 Infection in Adults Living with HIV","volume":"8","author":"Ambrosioni","year":"2021","journal-title":"Lancet HIV"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Wall, N., Godlee, A., Geh, D., Jones, C., Faustini, S., Harvey, R., Penn, R., Chanouzas, D., Nightingale, P., and O\u2019Shea, M. (2021). Latent Cytomegalovirus Infection and Previous Capsular Polysaccharide Vaccination Predict Poor Vaccine Responses in Older Adults, Independent of Chronic Kidney Disease. Clin. Infect. Dis.","DOI":"10.1093\/cid\/ciab078"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"e000140","DOI":"10.1136\/bmjdrc-2015-000140","article-title":"Predictors of the Antibody Response to Influenza Vaccination in Older Adults with Type 2 Diabetes","volume":"3","author":"McElhaney","year":"2015","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"5766","DOI":"10.1128\/JVI.00052-07","article-title":"Cytomegalovirus Infection in Gambian Infants Leads to Profound CD8 T-Cell Differentiation","volume":"81","author":"Miles","year":"2007","journal-title":"J. Virol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"328","DOI":"10.3389\/fimmu.2018.00328","article-title":"The Effect of Human Immunodeficiency Virus and Cytomegalovirus Infection on Infant Responses to Vaccines: A Review","volume":"9","author":"Falconer","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1093\/infdis\/jiz590","article-title":"Human Immunodeficiency Virus Exposure but Not Early Cytomegalovirus Infection Is Associated With Increased Hospitalization and Decreased Memory T-Cell Responses to Tetanus Vaccine","volume":"221","author":"Smith","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2042","DOI":"10.1016\/j.vaccine.2013.02.044","article-title":"Reduced Poliovirus Vaccine Neutralising-Antibody Titres in Infants with Maternal HIV-Exposure","volume":"31","author":"Manno","year":"2013","journal-title":"Vaccine"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Parmigiani, A., Alcaide, M.L., Freguja, R., Pallikkuth, S., Frasca, D., Fischl, M.A., and Pahwa, S. (2013). Impaired Antibody Response to Influenza Vaccine in HIV-Infected and Uninfected Aging Women Is Associated with Immune Activation and Inflammation. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0079816"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1097\/QAD.0000000000001774","article-title":"Impact of Aging and HIV Infection on Serologic Response to Seasonal Influenza Vaccination","volume":"32","author":"Pallikkuth","year":"2018","journal-title":"AIDS"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1056\/NEJMoa1706640","article-title":"Letermovir Prophylaxis for Cytomegalovirus in Hematopoietic-Cell Transplantation","volume":"377","author":"Marty","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Royston, L., Royston, E., Masouridi-Levrat, S., Vernaz, N., Chalandon, Y., Van Delden, C., and Neofytos, D. (2021). Letermovir Primary Prophylaxis in High-Risk Hematopoietic Cell Transplant Recipients: A Matched Cohort Study. Vaccines, 9.","DOI":"10.3390\/vaccines9040372"},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Royston, L., Royston, E., Masouridi-Levrat, S., Chalandon, Y., Van Delden, C., and Neofytos, D. (2021). Predictors of Breakthrough Clinically Significant Cytomegalovirus Infection during Letermovir Prophylaxis in High-Risk Hematopoietic Cell Transplant Recipients. Immun. Inflamm. Dis.","DOI":"10.3390\/vaccines9040372"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Rouphael, N.G., Hurwitz, S.J., Hart, M., Beck, A., Anderson, E.J., Deye, G., Osborn, B., Cai, S.Y., Focht, C., and Amegashie, C. (2019). Phase Ib Trial To Evaluate the Safety and Pharmacokinetics of Multiple Ascending Doses of Filociclovir (MBX-400, Cyclopropavir) in Healthy Volunteers. Antimicrob. Agents Chemother., 63.","DOI":"10.1128\/AAC.00717-19"},{"key":"ref_83","unstructured":"(2021, June 07). A Phase 3, Multicenter, Randomized, Open-Label, Active-Controlled Study to Assess the Efficacy and Safety of Maribavir Treatment Compared to Investigator-Assigned Treatment in Transplant Recipients with Cytomegalovirus (CMV) Infections that Are Refractory or Resistant to Treatment With Ganciclovir, Valganciclovir, Foscarnet, or Cidofovir, Available online: https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02931539."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Gugliesi, F., Coscia, A., Griffante, G., Galitska, G., Pasquero, S., Albano, C., and Biolatti, M. (2020). Where Do We Stand after Decades of Studying Human Cytomegalovirus?. Microorganisms, 8.","DOI":"10.3390\/microorganisms8050685"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s00430-019-00597-7","article-title":"Vaccine Vectors: The Bright Side of Cytomegalovirus","volume":"208","year":"2019","journal-title":"Med. Microbiol. Immunol."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Verweij, M.C., Hansen, S.G., Iyer, R., John, N., Malouli, D., Morrow, D., Scholz, I., Womack, J., Abdulhaqq, S., and Gilbride, R.M. (2021). Modulation of MHC-E Transport by Viral Decoy Ligands Is Required for RhCMV\/SIV Vaccine Efficacy. Science, 372.","DOI":"10.1126\/science.abe9233"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Malouli, D., Hansen, S.G., Hancock, M.H., Hughes, C.M., Ford, J.C., Gilbride, R.M., Ventura, A.B., Morrow, D., Randall, K.T., and Taher, H. (2021). Cytomegaloviral Determinants of CD8+ T Cell Programming and RhCMV\/SIV Vaccine Efficacy. Sci. Immunol., 6.","DOI":"10.1126\/sciimmunol.abg5413"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/7\/1266\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:26:41Z","timestamp":1760164001000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/7\/1266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,29]]},"references-count":87,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["v13071266"],"URL":"https:\/\/doi.org\/10.3390\/v13071266","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,29]]}}}