Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Int J Rheum Dis. 2020 Nov;23(11):1534-1540. doi: 10.1111/1756-185X.13990. Epub 2020 Oct 14.
We examined the relationship between cytomegalovirus (CMV) reactivation and serious infections.
We conducted a single-center retrospective chart review study with 43 autoimmune disease patients experiencing CMV reactivation. We investigated the risk factors for serious infections among the patients using logistic regression analysis.
We identified that the maximum count of CMV antigenemia during the course of infection (CMV Ag MAX) was significantly associated with serious infection by multivariate analysis (adjusted odds ratio: 1.509; 95% confidence interval: 1.071-2.125). The receiver operating characteristic curve of CMV Ag MAX count showed a predictive value for serious infections (76.9% in sensitivity and 93.3% in specificity) and death (83.3% in sensitivity and 91.9% in specificity), and the cut-off count of serious infections and death was 6 and 10 per 10 white blood cell count, respectively.
We suggest that the counts of CMV Ag MAX can reflect the extent of compromise in the immune system, and can be a predictive marker for serious infections and death.
我们研究了巨细胞病毒（CMV）再激活与严重感染之间的关系。
我们进行了一项单中心回顾性图表审查研究，纳入了 43 例发生 CMV 再激活的自身免疫性疾病患者。我们使用逻辑回归分析调查了患者发生严重感染的风险因素。
我们发现，在感染过程中 CMV 抗原血症的最高计数（CMV Ag MAX）与严重感染在多变量分析中显著相关（调整后的优势比：1.509；95%置信区间：1.071-2.125）。CMV Ag MAX 计数的受试者工作特征曲线显示对严重感染（敏感性为 76.9%，特异性为 93.3%）和死亡（敏感性为 83.3%，特异性为 91.9%）具有预测价值，严重感染和死亡的临界计数分别为每 10 个白细胞 6 和 10。
我们建议 CMV Ag MAX 的计数可以反映免疫系统受损的程度，并且可以作为严重感染和死亡的预测标志物。
