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Real‐Time PCR of cytomegalovirus and Epstein–Barr virus in adult E gyptian patients with systemic lupus erythematosus
Author(s) -
Mohamed Aly E.,
Hasen Amany M.,
Mohammed Ghada F. A.,
Elmaraghy Nermin N.
Publication year - 2015
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12261
Subject(s) - medicine , rheumatology , immunology , antibody , cytomegalovirus , epstein–barr virus , systemic lupus erythematosus , virus , lupus erythematosus , serology , herpesviridae , disease , gastroenterology , viral disease
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 E gyptian 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 E gyptian 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.