title: Risk factors associated with elevated blood cytomegalovirus pp65 antigen levels in patients with autoimmune diseases.
abstract: OBJECTIVE
  To further assess the relationship between elevated levels of cytomegalovirus (CMV) pp65 antigen in blood, as indicative of viral load, during treatment-free follow-up and CMV diseases in patients with autoimmune diseases and to identify any risk factors associated with elevated viral loads.
  
  
  METHODS
  This was a retrospective review of the electronic medical charts of 148 patients with autoimmune diseases who tested positive for CMV pp65 antigen in the blood.
  
  
  RESULTS
  A total of 106 patients were analyzed. During follow-up, elevated viral loads were detected in 35 patients who were not on antiviral therapy, of whom five developed CMV diseases. Elevated viral load was significantly associated with CMV diseases [5/35 vs. 0/71 (no elevated viral load); P = 0.001). Multivariate analysis revealed that lymphopenia [lymphocyte numbers <700/mm(3), odds ratio (OR) 34.44, 95 % confidence interval (CI), 7.82-151.66; P < 0.001], systemic lupus erythematosus (SLE) (OR 6.71, 95 % CI, 1.23-36.49; P = 0.028), and polymyositis/dermatomyositis (PM/DM) (OR 10.62, 95 % CI 1.41-79.77; P = 0.022) were significantly associated with elevated viral load.
  
  
  CONCLUSIONS
  Elevated viral load was significantly associated with CMV diseases. Patients with SLE or PM/DM and lymphopenia would therefore benefit from a detailed viral load follow-up and careful physical examination.
authors.affiliation: Department of Infection Control and Prevention, Kyoto University Hospital, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, Kyoto 606-8507, Japan.
authors.forename: Daichi
authors.initials: D
authors.lastname: Fujimoto
authors.forename: Aki
authors.initials: A
authors.lastname: Matsushima
authors.forename: Miki
authors.initials: M
authors.lastname: Nagao
authors.forename: Shunji
authors.initials: S
authors.lastname: Takakura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ichiyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000097:blood / Q000150:complications / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010750:Phosphoproteins / Q000097:blood*; D012189:Retrospective Studies; D012307:Risk Factors; D019562:Viral Load; D014763:Viral Matrix Proteins / Q000097:blood*
chemical_list: D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa