Division of Infectious Disease, Konkuk University medical center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.
BMC Infect Dis. 2021 May 4;21(1):414. doi: 10.1186/s12879-021-06098-4.
Reactivation of human cytomegalovirus (CMV) occurs in non-immunocompromised patients with or without specific organ involvement, but it is still unknown whether it has a clinical implication on long-term prognosis or not.
A retrospective cohort study evaluating non-immunocompromised adult patients with CMV reactivation was conducted during the period between January 2010 and February 2018. Patients were divided into ganciclovir-treated and non-treated groups. Patients who died within 30 days from CMV reactivation were excluded as they died from complex causes of conditions. Survivors were followed for 30-months to evaluate long-term prognosis.
A total of 136 patients with CMV reactivation was included, consisting of 66 ganciclovir-treated (48.5%) and 70 non-treated (51.5%) patients. Overall, patients were old-aged (median 70 years old) and most were treated with pneumonia of any cause (91.2%). More patients in ganciclovir-treated group were treated at intensive care unit (43.9% vs 24.3%, respectively) and had higher viral load over 5000 copies/ml (48.5% vs 22.9%) than non-treated group (all P < 0.05). Primary and secondary endpoints including 30-months survival (28.0 vs 38.9%, respectively) and 12-months survival (40.3% vs 49.2%) were not statistically different between the ganciclovir-treated and non-treated groups. In the multivariate analyses, ganciclovir treatment was not associated with 30-months survival (HR 1.307, 95% CI 0.759-2.251) and 12-months survival (HR 1.533, 95% CI 0.895-2.624).
In a retrospective cohort study evaluating non-immunocompromised patients with CMV reactivation, ganciclovir treatment was not associated with long-term prognosis. Antiviral treatment in this condition would not be necessary unless organ involvement is suspected.
人类巨细胞病毒（CMV）在非免疫功能低下的患者中重新激活，无论是否有特定器官受累，但尚不清楚它是否对长期预后有临床意义。
我们进行了一项回顾性队列研究，评估了 2010 年 1 月至 2018 年 2 月期间 CMV 重新激活的非免疫功能低下的成年患者。患者分为更昔洛韦治疗组和非治疗组。由于患者死于复杂的疾病原因，从 CMV 重新激活后 30 天内死亡的患者被排除在外。幸存者随访 30 个月以评估长期预后。
共纳入 136 例 CMV 重新激活患者，其中更昔洛韦治疗组 66 例（48.5%），非治疗组 70 例（51.5%）。总体而言，患者年龄较大（中位数 70 岁），大多数因任何原因导致肺炎（91.2%）。更昔洛韦治疗组中更多的患者在重症监护病房接受治疗（分别为 43.9%和 24.3%），病毒载量高于 5000 拷贝/ml 的比例更高（分别为 48.5%和 22.9%）（均 P < 0.05）。主要和次要终点包括 30 个月生存率（分别为 28.0%和 38.9%）和 12 个月生存率（分别为 40.3%和 49.2%）在更昔洛韦治疗组和非治疗组之间无统计学差异。在多变量分析中，更昔洛韦治疗与 30 个月生存率（HR 1.307，95%CI 0.759-2.251）和 12 个月生存率（HR 1.533，95%CI 0.895-2.624）无关。
在一项评估非免疫功能低下的 CMV 重新激活患者的回顾性队列研究中，更昔洛韦治疗与长期预后无关。除非怀疑有器官受累，否则该情况下无需进行抗病毒治疗。
