Incidence of Cytomegalovirus Reactivation in Patients with Inflammatory Connective Tissue Diseases Who Are Under Immunosuppressive Therapy

TAKEHIKO MORI, HIDETO KAMEDA, HIROE OGAWA, ATSUSHI IIZUKA, NAOYA SEKIGUCHI, HIROFUMI TAKEI, HAYATO NAGASAWA, MICHIHIDE TOKUHIRA, TOSHIO TANAKA, YUMIKO SAITO, KOICHI AMANO, TORU ABE, and TSUTOMU TAKEUCHI

ABSTRACT.

Objective. To evaluate the incidence and effect of cytomegalovirus (CMV) reactivation in patients with inflammatory connective tissue diseases (CTD) undergoing immunosuppressive therapy.

Methods. A total of 18 consecutive CMV seropositive patients undergoing immunosuppressive therapy for inflammatory CTD were enrolled. CMV reactivation was determined by detection of CMV-DNA in peripheral blood leukocytes (PBL) or plasma using quantitative real-time polymerase chain reaction.

Results. CMV reactivation was detected in PBL in 7 of 17 evaluable patients (41%), and in plasma in 5 of 17 patients (29%). Patients with detectable CMV-DNA in plasma were exclusively positive for CMV-DNA in PBL.

Conclusion. Patients with inflammatory CTD under immunosuppressive therapy are at high risk for CMV reactivation. The clinical significance of such an event and indications for antiviral therapy should be examined further. (J Rheumatol 2004;31:1349-51)

Key Indexing Terms:

CYTOMEGALOVIRUS
REACTIVATION
INFLAMMATORY CONNECTIVE TISSUE DISEASE

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From the Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School, Kawagoe, Saitama; the Division of Hematology-Infectious Diseases-Rheumatology, Department of Medicine, Keio University School of Medicine, Tokyo; and the Department of Infection and Immunology, SRL Inc., Tokyo, Japan.

T. Mori, MD, PhD; H. Kameda, MD, PhD; H. Ogawa, MD; A. Iizuka, MD; N. Sekiguchi, MD; H. Takei, MD; H. Nagasawa, MD; M. Tokuhira, MD, PhD; K. Amano, MD, PhD; T. Abe, MD, PhD; T. Takeuchi, MD, PhD, Second Department of Internal Medicine, Saitama Medical Center, Saitama Medical School; T. Mori, MD, PhD, Division of Hematology-Infectious Diseases-Rheumatology, Department of Medicine, Keio University School of Medicine; T. Tanaka, MAg, Section Chief; Y. Saito, BSc, Director, Department of Infection and Immunology, SRL Inc.

Address reprint requests to Dr. T. Mori, Division of Hematology-Infectious Diseases-Rheumatology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. E-mail: tmori@sc.itc.keio.ac.jp

Submitted June 4, 2003; revision accepted January 28, 2004.

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