Active human herpesvirus infections in adults with systemic lupus erythematosus and correlation with the SLEDAI score

Abstract

Background Human herpesviruses (HHVs) are responsible for a significant number of clinical manifestations in systemic lupus erythematous (SLE) patients. The aim of this study was to determine the frequency of active HHV infections in SLE patients and correlating them with disease activity. Methods Serum samples were collected from 71 SLE patients and their DNAs were extracted and analyzed to detect HHV-DNA viruses using the nucleic acid amplification technique. Results Fifteen out of the 71 (21.1%) patients tested positive for the HHV-DNA virus. Of them, 11/15 HHV-DNA-positive patients (73.3%) had SLE activity index (SLEDAI – Systemic Lupus Erythematosus Disease Activity Index) ≥8 (p = 0.0001). Active HCMV infection was the mostly frequently observed infection, occurring in 6/15 patients (40%). The frequencies of other active viral infections were 22% for HSV-1, 16.7% for HHV-7, and 5.5% for HSV-2. Viral coinfection (two or more viruses detected in the same sample) occurred in three patients (16.7%). Active HHV infections in SLE patients are more frequent in those with active SLE (≥8), who is at high risk of HHV reactivation and HCMV disease. Conclusion Viral surveillance is important to identify active HHV infections that can cause clinical symptoms and other complication in SLE patients.

Evaluation of herpesvirus members on hospital admission in patients with systemic lupus erythematous shows higher frequency of Epstein-Barr virus and its associated renal dysfunction

“…Infections are common in patients with SLE, resulting partly from immunosuppressive treatment and immune system disruption associated with SLE and are associated with high morbidity and mortality 10 . The identification and correlation of active human herpesvirus with clinical complications in SLE patients with high SLEDAI scores is very important, as is the early search for members of the herpes family such as the CMV in the first days of hospitalization of patients with autoimmune diseases 3 , 11 . For example, subjects with SLE might exhibit increased susceptibility for EBV and/or CMV and HHV-6 reactivation with or without implications in disease exacerbation 12 .…”

“…This family includes the following viruses: herpes simplex virus 1 and 2 (HSV-1 and HSV-2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpes virus 6 and 7 (HHV-6 and HHV-7), and the Kaposi’s sarcoma-associated herpesvirus 8 (HHV-8) 2 . Herpesviruses have been reported in case series of SLE patients as an emergent issue, including triggering of SLE itself and its activity, through viral reactivation mechanisms and immune-inflammatory disturbance 3 . Recently, a relationship between SLE, chronic kidney disease, and EBV load has been suggested 4 .…”

Seroprevalence of Toxoplasma Gondii infection in patients with Systemic Lupus Erythematosus

“…Estas infecciones, pueden ser causadas por microorganismos comunes o por oportunistas, entre los que se encuentra el Toxoplasma gondii (T. gondii), sobre todo debido a la terapia inmunosupresora que reciben estos pacientes 4,5 . Para caracterizar la actividad del LES se utiliza como criterio una medida de la enfermedad activa SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) que según lo recomendado por el American College of Rheumatology y los protocolos internos estima LES activo cuando el SLEDAI del paciente es mayor o igual a 8 6,7 .…”

Cytomegalovirus-Associated Autoantibody against TAF9 Protein in Patients with Systemic Lupus Erythematosus

“…Several autoimmune disorders have been linked to CMV infection, particularly SLE [3]. Active CMV infections that are more frequently observed in SLE patients with active disease are related to the clinical manifestations and other complications [4]. CMV infection increases Ro/La protein expression on keratinocytes and laboratory cell lines [5,6].…”