Open AccessRisk factors for cytomegalovirus infection in patients with antineutrophil cytoplasmic antibody-associated vasculitis
Author(s) -
Michiko Morishita,
KenEi Sada,
Yoshinori Matsumoto,
Keigo Hayashi,
Yosuke Asano,
Sumie Hiramatsu Asano,
Keiji Ohashi,
Yoshia Miyawaki,
Eri Katsuyama,
Hirotaka Watanabe,
Tomoko Kawabata,
Jun Wada
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0218705
Subject(s) - medicine , vasculitis , odds ratio , anti neutrophil cytoplasmic antibody , granulomatosis with polyangiitis , microscopic polyangiitis , confidence interval , cytomegalovirus , immunosuppression , gastroenterology , immunology , disease , viral disease , herpesviridae , virus
Aims Cytomegalovirus (CMV) infection under immunosuppression sometimes causes death. This study aimed to elucidate risk factors for CMV infection in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods Patients with AAV who underwent remission induction treatment at Okayama University Hospital between 2006 and 2016 were retrospectively analyzed. The primary outcome was the development of CMV infection within 3 months. Results Of the 111 patients, 13 (11.7%) patients developed CMV infection. Patients with CMV infection were older ( p = 0.030) and had a higher body mass index ( p = 0.029) in comparison to those without CMV infection. A higher proportion had a severe form ( p = 0.001) and granulomatosis with polyangiitis (GPA) ( p = 0.001), as well as a higher Birmingham Vasculitis Activity Score ( p = 0.018) and C-reactive protein ( p = 0.018) levels at baseline. Using logistic regression analysis, severe form and GPA were independent risk factors (odds ratio [OR] = 9.68, 95% confidence interval [CI] = 1.92–60.23, and OR = 7.46, 95% CI = 1.46–47.60, respectively). In addition, patients with CMV infection were more likely than those without infection to be glucocorticoid-related diabetes mellitus ( p = 0.025). Conclusion Our study highlights disease severity and subgroups of AAV as risk factors for CMV infection.