Variants of HCMV UL18 Sequenced Directly from Clinical Specimens Associate with Antibody and T-Cell Responses to HCMV

Around 80% of adults worldwide carry human cytomegaloviris (HCMV). The HCMV gene is a homolog of HLA class I genes and encodes a protein with high affinity for the NK and T-cell cytotoxicity inhibitor LIR-1. was deep sequenced from blood, saliva or urine from Indonesian people with HIV (PWH) ( = 28), Australian renal transplant recipients (RTR) ( = 21), healthy adults ( = 7) and neonates ( = 4). 95% of samples contained more than one variant of HCMV , as defined by carriage of nonsynonymous variations. When aligned with immunological markers of the host's burden of HCMV, the S318N variation associated with high levels of antibody reactive with HCMV lysate in PWH over 12 months on antiretroviral therapy. The A107T variation associated with HCMV antibody levels and inflammatory biomarkers in PWH at early timepoints. Variants D32G, D248N, V250A and E252D aligned with elevated HCMV antibody levels in RTR, while M191K, E196Q and F165L were associated with HCMV-reactive T-cells and proportions of Vδ2 γδ T-cells-populations linked with high burdens of HCMV. We conclude that is a highly variable gene, where variation may alter the persistent burden of HCMV and/or the host response to that burden.