title: Sepsis and cytomegalovirus: foes or conspirators?
abstract: Cytomegalovirus (CMV) reactivation in non-immune-suppressed critically ill patients is an area of increasing interest. CMV has long been appreciated as a pathogen in immunocompromised hosts. CMV reactivates in approximately one-third of latently infected non-immune-suppressed hosts during critical illness; however, its role as a pathogen in these patients remains unclear. CMV reactivation has been linked to bacterial sepsis and likely results from inflammation, transient immune compromise, and viral epigenetic changes. While CMV may improve immune response to some bacterial infections, other data suggest that CMV induces exaggerated responses to severe infections that may be harmful to latently infected hosts. These results also suggest that previous infection history may explain significant differences seen between human septic responses and murine models of sepsis. While critically ill human hosts clearly have worse outcomes associated with CMV reactivation, determining causality remains an area of investigation, with randomized control trials currently being performed. Here we review the current literature and highlight areas for future investigation.
authors: Department of Surgery, The Ohio State University Medical Center, Columbus, OH, 43210, USA.
authors: Sara
authors: S
authors: Mansfield
authors: Marion
authors: M
authors: Grießl
authors: Michael
authors: M
authors: Gutknecht
authors: Charles H
authors: CH
authors: Cook
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism / Q000821:virology*; D054884:Host-Pathogen Interactions; D006801:Humans; D051379:Mice; D018805:Sepsis / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism / Q000821:virology*; D014775:Virus Activation / Q000276:immunology
chemical_list: D000998:Antiviral Agents