title: Real-Time PCR of cytomegalovirus and Epstein-Barr virus in adult Egyptian patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  Infections may act as environmental triggers for induction of systemic lupus erythematosus (SLE). We sought to explore the relative frequencies of Epstein-Barr virus (EBV) and human cytomegalovirus (CMV) in adult Egyptian patients with SLE and their correlation with disease activity and damage.
  
  
  METHODS
  Thirty-three consecutive adult patients satisfying the 1997 American College of Rheumatology (ACR) Classification Criteria for SLE and 30 healthy controls were included in this case-control study. All patients were subjected to complete clinical and laboratory evaluation to determine the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR). Sera from both groups were analyzed for immunoglobulin M (IgM) and IgG antibodies against CMV and EBV. Qualitative real time polymerase chain reaction (PCR) for both viruses was performed for all SLE patients.
  
  
  RESULTS
  Almost all SLE patients 32/33 (96.9%) were positive for IgG anti-CMV antibodies versus 20/30 in the control group (66.6%) (P = 0.002). All SLE patients were positive for IgG anti-EBV antibodies compared to 25 in the control group (100% vs. 83.3%, P = 0.02). CMV and EBV DNA were detected by PCR in 30.3% and 51.5% of SLE patients, respectively. A statistically significant lower SLEDAI was found in PCR positive patients for EBV compared to negative patients (9.6 ± 5.2 vs. 13.1 ± 3.1, respectively P = 0.041).
  
  
  CONCLUSIONS
  Adult Egyptian patients with SLE had higher frequencies of anti-CMV and EBV IgG compared to healthy controls. Furthermore, our single point assessment of SLEDAI suggested that exposure to EBV infection might be associated with a lower disease activity.
authors.affiliation: Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
authors.forename: Aly E
authors.initials: AE
authors.lastname: Mohamed
authors.affiliation: Department of Clinical and Chemical Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
authors.forename: Amany M
authors.initials: AM
authors.lastname: Hasen
authors.affiliation: Department of Dermatology and Venereology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
authors.forename: Ghada F A
authors.initials: GF
authors.lastname: Mohammed
authors.affiliation: Department of Medical Microbiology and Immunology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
authors.forename: Nermin N
authors.initials: NN
authors.lastname: Elmaraghy
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D015897:Comorbidity; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D004279:DNA, Viral / Q000032:analysis; D003906:Developing Countries; D004534:Egypt / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology*; D008297:Male; D011379:Prognosis; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D018570:Risk Assessment; D012698:Serologic Tests; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: Epstein-Barr virus; cytomegalovirus; real-time PCR; serology; systemic lupus erythematosus