CMV Titers Associated With Differential Survival in Rheumatic Diseases

WASHINGTON DC — High cytomegalovirus (CMV) titers are associated with increased mortality rates in patients with rheumatic diseases, according to a study presented at American College of Rheumatology Annual Meeting 2016.¹

Using data from Severance Hospital, researchers from Yonsei University College of Medicine in Seoul, South Korea, conducted a retrospective study between 2005 and 2016 reviewing medical records of patients with rheumatic disease and comorbid CMV infection. Immunosuppresive treatment regimen, CMV titer by real time polymerase chain reaction (RT-PCR), and anti-viral treatment were collected.

A total of 68 patients with rheumatic disease and CMV infection were evaluated.  Their mean age was 56 years and mean disease duration was 6.4 years with 22 deaths.

Patients in the upper tertile CMV group had significantly increased mortality rates compared with patients in the lower tertile CMV group P <.05),

When comparing those patients who survived with those who did not, researchers found that a history of mechanical ventilation was significantly associated with increased mortality (13 [59.1%] vs 3 [6.5%],  P < .0001).

“High CMV titer is associated with mortality in rheumatic disease patients even though anti-viral treatment was not associated with mortality,” the researcher concluded.  These findings suggest that CMV infection may play a role in ongoing systemic inflammatory or immunomodulatory functions, however it should be noted that high CMV titers were not shown to be a direct cause of mortality in this study.

The findings in this study need to be confirmed in larger studies, the researchers noted, since it is unknown if CMV titer is the direct cause of mortality or the result of critical condition.

Reference 

Lee KY, Jung SM, Lee SW, Park YB, Song JJ. Predictors of mortality in rheumatic disease patients with CMV infection. Presented at: the 2016 American College of Rheumatology/ Association of Rheumatology Health Professionals (ACR/ARHP) Annual Meeting. November 11-16, 2016; Washington, DC. Abstract #1352