Batalla A-S, Benito D, Baumard S, Brodard V, Servettaz A, Jaussaud R, Strady C
Service de médecine interne et des maladies infectieuses, hôpital Robert-Debré, avenue du Général-Koenig, Reims cedex, France.
Med Mal Infect. 2011 Jan;41(1):14-9. doi: 10.1016/j.medmal.2010.07.012. Epub 2010 Sep 15.
The objective of this study was to compare epidemiological, clinical, and biological data of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) primary infections in immunocompetent adults, admitted in the infectious disease department of the Reims Teaching Hospital between 2000 and 2005.
Inclusion criteria were the presence of anti-VCA IgM antibodies or the presence of CMV specific IgM antibodies and the absence of any other positive serology. Differences in reported percentage were compared with a Khi(2) test or Fischer's exact test, when appropriate. Continuous variables were compared with the Mann-Whitney Test.
There were no significant changes over the years in the numbers of EBV (n=32) and CMV (n=20) primary infections. The patient's mean age was 22.7 years (14-48 years) in EBV primary infections and 38.6 years (13-66 years) in CMV primary infections (P<0.01). The clinical variables significantly associated with primary EBV infection were sore throat and cervical lymphadenopathy (P<0.01). Arthromyalgia and respiratory manifestations were less frequent in EBV primary infection (P<0.01). The biological variables significantly associated with EBV primary infection were a marked alanine aminotransferase elevation and a marked lymphocytosis with atypical lymphocytes (P<0.001). Thrombopenia was less frequently associated with EBV primary infection (P<0.001).
Clinical and biological presentations of EBV and CMV primary infections were similar. The simultaneous serologic diagnosis of these two infections remains necessary to provide a specific diagnosis, for the most efficient patient care.
本研究的目的是比较2000年至2005年间入住兰斯教学医院传染病科的免疫功能正常成年人中,爱泼斯坦-巴尔病毒(EBV)和巨细胞病毒(CMV)初次感染的流行病学、临床和生物学数据。
纳入标准为存在抗VCA IgM抗体或CMV特异性IgM抗体,且无任何其他阳性血清学检查结果。报告百分比的差异在适当情况下采用卡方检验或费舍尔精确检验进行比较。连续变量采用曼-惠特尼检验进行比较。
多年来EBV(n = 32)和CMV(n = 20)初次感染的数量无显著变化。EBV初次感染患者的平均年龄为22.7岁(14 - 48岁),CMV初次感染患者的平均年龄为38.6岁(13 - 66岁)(P < 0.01)。与EBV初次感染显著相关的临床变量为咽痛和颈部淋巴结肿大(P < 0.01)。EBV初次感染时关节痛和呼吸道表现较少见(P < 0.01)。与EBV初次感染显著相关的生物学变量为显著的丙氨酸转氨酶升高和伴有非典型淋巴细胞的显著淋巴细胞增多(P < 0.001)。血小板减少与EBV初次感染的相关性较低(P < 0.001)。
EBV和CMV初次感染的临床和生物学表现相似。为了提供特异性诊断并实现最有效的患者护理,同时进行这两种感染的血清学诊断仍然是必要的。