Abstract Background T cell receptor (TCR) convergence refers to the phenomenon whereby antigen-driven selection enriches for TCRs having shared antigen specificity but different nucleotide sequences. Previous work has demonstrated the potential utility of TCR convergence as a predictive biomarker for response to checkpoint blockade and dendritic cell based immunotherapy for cancer. The extent to which convergence arises owing to chronic viral infection is not yet established. Here we sought to identify features of chronic cytomegalovirus (CMV) infection using TCRB profiling of peripheral blood (PBL) total RNA. Methods Total RNA from PBL was obtained from 35 blood donors of known CMV status, then used for TCRB sequencing via the Oncomine TCRB-LR assay (amplicon spanning CDR 1, 2 and 3) and the Ion Torrent S5. In parallel, we prepared libraries via the Oncomine TCRB-SR assay (CDR3 only). Data were used to identify TCRB repertoire features correlated with CMV status and compare repertoire features across the two assays. For context, we compare CMV-related convergence to previous reports detailing convergent T cell responses in individuals with cancer. Results T cell clone evenness was reduced in CMV positive individuals irrespective of age, predictive of CMV status (AUC=.86, p=2E-4, Wilcoxon), and strongly correlated between LR and SR assays (Spearman cor=.96). TCR convergence was elevated in CMV positive individuals and uncorrelated with evenness (Spearman cor = -.03) such that the combination of convergence and evenness improved the performance of a logistic regression classifier (AUC= .93). Conclusions We identify reduced T cell evenness and elevated TCR convergence as features of chronic CMV infection. CMV infection appears to significantly alter the T cell repertoire, suggesting that CMV status may be required for proper interpretation of T cell expansion in the context of immunotherapy for cancer. TCR convergence may detect T cell responses to a broad range of viral and tumor neoantigens and thus may serve as a particularly useful biomarker for the identification of immunogenic tumors having few genetic alterations. Citation Format: Timothy J. Looney. Peripheral blood TCRB chain convergence in chronic viral infection and cancer: Emerging trends from a novel immune repertoire biomarker [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1347.