San-Juan R, Fernández-Ruiz M, Ruiz-Ruigómez M, et al. - Researchers sought to develop a composite score based on EBVd and simple clinical and immunological parameters that may assist in predicting late severe infection (LI) beyond month 6 in SOT recipients. Between May 2014-August 2016, kidney and liver transplant recipients at four participating centers were assessed for serum immunoglobulins and complement factors, peripheral blood lymphocyte subpopulations, and whole-blood EBVd at months 1, 3 and 6. Via Cox regression analyses, a weighted score for the prediction of LI was developed. The following variables at month 6 were included in the CLIV score: high-level EBVd (> 1,500 IU/ml) and recurrent infection during the previous months (6 points); recipient age ≥ 70 years and chronic graft dysfunction (5 points); CMV mismatch (4 points); and CD8+ T-cell count < 400 cells/μL (2 points). Follow up of overall, 309 SOT recipients was performed for a median of 1,000 days from transplant (IQR: 822-1124). Of these, 104 patients (33.6%) experienced LI. Although further external validation is required, this analysis suggests a potential utility of CLIV-score to stratify the risk of LI after SOT.