title: Positive Epstein-Barr virus detection and mortality in respiratory failure patients admitted to the intensive care unit.
abstract: BACKGROUND
  Epstein-Barr virus (EBV) infection may induce immune suppression in several ways, which may influence the proper host response to other pathogens and lead to a bad outcome of critically ill patients.
  
  
  METHODS
  This was a single-center, retrospective, observational study. All patients admitted to an ICU because of respiratory failure were included. EBV detection from lower respiratory tract (LRT) and serum samples were routinely performed.
  
  
  RESULTS
  Twenty-eight consecutive cases who were admitted to the ICU at high-risk for an infection or clinical signs of an infection were included in our study. Among the 28 patients, 15 were LRT-positive for EBV (53.6%), and 8 were seropositive for EBV (28.6%). Among the LRT EBV-positive patients, pneumonia was the main indication for ICU admission (93.3%), and in LRT EBV-negative patients, acute exacerbation of COPD (AECOPD) was another indication for ICU admission (46.2%). The CD3+ T cell count (especially the CD3+CD8+ T cell count) was lower than the normal range in LRT- and serum EBV-positive patients; these count were in the normal range in EBV-negative patients. The ICU mortality was 32.1% for all patients. The mortality rate was significantly higher in patients who were seropositive for EBV than seronegative patients (62.5% vs 20.0%). No differences were shown between any outcome parameters for LRT EBV-positive and -negative patients.
  
  
  CONCLUSIONS
  This study showed that EBV DNA is detected in LRT and serum samples of a significant number of ICU patients with respiratory failure, and seropositivity for EBV was associated with mortality. This finding maybe correlated with a low CD3+CD8+ T cell count.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 10020, China.
authors.forename: Hangyong
authors.initials: H
authors.lastname: He
authors.affiliation: Department of No.1 Internal Medicine, the Shihua Hospital of Luoyang, Luoyang, Henan Province, 471012, China.
authors.forename: Yajing
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Critical Care Medicine, Heilongjiang Province Hospital, Harbin, Heilongjiang Province, 150036, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Wu
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 10020, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017252:CD3 Complex / Q000097:blood; D016827:CD8 Antigens / Q000097:blood; D016638:Critical Illness / Q000453:epidemiology / Q000401:mortality; D004267:DNA Viruses / Q000235:genetics; D020031:Epstein-Barr Virus Infections / Q000097:blood / Q000150:complications* / Q000401:mortality*; D005260:Female; D004854:Herpesvirus 4, Human / Q000235:genetics / Q000302:isolation & purification*; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000097:blood / Q000175:diagnosis / Q000821:virology; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000175:diagnosis / Q000821:virology; D012131:Respiratory Insufficiency / Q000097:blood / Q000453:epidemiology / Q000401:mortality* / Q000821:virology; D012141:Respiratory Tract Infections / Q000150:complications / Q000821:virology; D012189:Retrospective Studies; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D017252:CD3 Complex; D016827:CD8 Antigens
keywords: Barr virus; Epstein; immune function; intensive care unit; prognosis; respiratory failure