Association between mortality and cytomegalovirus reactivation during remission induction therapy in patients with rheumatic diseases

Abstract

ObjectiveTo elucidate the characteristics of patients with rheumatic diseases with cytomegalovirus (CMV) reactivation. MethodsIn our study, we consecutively reviewed patients with rheumatic diseases who received remission induction therapy in our institution from January 2012 to March 2016 and enrolled the patients who were evaluated about CMV infection.CMV reactivation was characterised by the detection of polymorphonuclear leukocytes with CMV pp65. The characteristics and clinical courses of the patients with CMV reactivation were compared to those without CMV.

The Contribution of Human Herpes Viruses to γδ T Cell Mobilisation in Co-Infections

“…In the absence of obvious immunosuppression, reactivations of latent viruses are reported during sepsis with a frequency similar to that observed in HCT patients [32][33][34], during acute respiratory distress syndrome, during viral infections, non-tuberculous mycobacterial diseases [32,35] and non-infectious inflammatory contexts, such as atopic dermatitis [34] and rheumatic diseases [36].…”

Risk factors associated with cytomegalovirus reactivation in patients receiving immunosuppressive therapy for rheumatic diseases: a retrospective study

“…Corticosteroids suppress the activation of lymphocytes, especially CD4 T lymphocytes, that may affect susceptibility to CMV reactivation 18 – 20 . Previous reports mentioned that higher dose of PSL was especially influential in CMV reactivation 2 – 5 , 10 , 21 . However, regarding detailed usage, especially about initial dose and PSL duration, these opinions remain controversial.…”

“…Concerning the past CMV infection, a previous report mentioned that CMV-specific immunoglobulin G (CMV-IgG) level was not significantly related to CMV reactivation 21 . Our study also showed no significance of CMV-IgG positivity (Supplementary Table 2 ).…”

Factors associated with cytomegalovirus antigenemia in patients with rheumatic disease: A retrospective study

“…The cutoff value for each factor was determined by creating receiver operating characteristic curve (ROC) and using the Youden index. In actual clinical practice, lymphocytes and IgG may be monitored as indicators of CMV reactivation [24]. Therefore, to evaluate the strength of the association of CMV antigenemia with the steroid dose, lymphocyte count, and IgG, the area under the curve (AUC) was compared using the ROC curve.…”

“…Of the patients with rheumatic diseases included in this study, 33.7% presented with CMV antigenemia. Previous reports have shown that the frequency of CMV antigenemia varies widely from 3% to 40% [15,[17][18][19][20][21]24,26]. This difference was attributed to the type of the underlying rheumatic disease.…”