Division of Clinical Laboratory, Tottori University Hospital, Yonago, Tottori, Japan.
Division of Clinical Laboratory Medicine, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Tottori, Japan.
J Int Med Res. 2020 Nov;48(11):300060520972880. doi: 10.1177/0300060520972880.
Co-reactivation of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) occurs in iatrogenically immunosuppressed patients, but the clinical relevance of this is unknown. We aimed to determine the frequency of EBV reactivation in patients with CMV viremia and to explore its clinical significance.
Serum or plasma CMV and EBV DNA was detected by quantitative real-time PCR in 82 patients who received immunosuppressive therapy and/or chemotherapy and underwent CMV antigenemia tests.
CMV DNA was positive in 55 patients, with EBV reactivation being found in 29 of these (52.7%). EBV co-reactivation was significantly associated with aging (>64 years vs. ≤64 years, odds ratio 4.07, 95% confidence interval 1.06-15.6). When older patients were divided into two groups according to age, EBV co-reactivation occurred more frequently in early-old patients (aged 65-74 years) than in late-old patients (aged ≥75 years) (100.0% vs. 53.3%, respectively). Steroid pulse treatment was administered significantly more often in the early-old group than in those aged ≤64 years and ≥75 years (72.7% vs 27.6% vs 14.3%, respectively).
Co-reactivation of EBV in patients with CMV viremia highlighted early-old patients and may reflect treatment intensity as well as immunosenescence.
在医源性免疫抑制患者中，巨细胞病毒（CMV）和 EBV 会同时再激活，但这种再激活的临床意义尚不清楚。本研究旨在确定 CMV 血症患者中 EBV 再激活的频率，并探讨其临床意义。
对接受免疫抑制治疗和/或化疗且进行 CMV 抗原血症检测的 82 例患者的血清或血浆 CMV 和 EBV DNA 采用实时荧光定量 PCR 法进行检测。
55 例患者的 CMV DNA 呈阳性，其中 29 例（52.7%）存在 EBV 再激活。EBV 共同再激活与年龄较大（>64 岁与≤64 岁，比值比 4.07，95%置信区间 1.06-15.6）显著相关。当将老年患者根据年龄分为两组时，早期老年患者（65-74 岁）的 EBV 共同再激活发生率高于晚期老年患者（≥75 岁）（分别为 100.0%和 53.3%）。早期老年组比≤64 岁组和≥75 岁组更常接受类固醇脉冲治疗（分别为 72.7%、27.6%和 14.3%）。
CMV 血症患者中 EBV 的共同再激活突出了早期老年患者，这可能反映了治疗强度以及免疫衰老。
