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Article Abstract
Background: Tissue-invasive end-organ disease (EOD) caused by cytomegalovirus (CMV) is less frequently reported in immunocompetent patients compared to immunocompromised patients. In this study, we investigated the association between CMV viremia and CMV end-organ disease in immunocompetent patients.
Methods: Adult patients (≥18 years old) with CMV viremia were screened from January 2010 to June 2022. The primary outcome was the presence of CMV EOD. Risk factors associated with CMV EOD were analyzed, and a receiver operating characteristic curve was plotted to determine the most accurate cutoff value of the CMV titer for the prediction of CMV EOD.
Results: Among the 106 immunocompetent patients with CMV viremia, 31 exhibited CMV EOD. Gastrointestinal tract disease was the most common. The log10 value of the CMV titer was significantly associated with the occurrence of CMV EOD in immunocompetent patients with CMV viremia. The optimal cut-off CMV titer for the prediction of CMV EOD was 749 IU/mL.
Conclusions: Our study suggests the potential association between high CMV titers and the development of CMV end-organ diseases and describes the diagnostic performance and utility of quantitative PCR as a surrogate marker for predicting the occurrence of CMV EOD in immunocompetent patients.
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| http://dx.doi.org/10.1016/j.jiph.2024.102542 | DOI Listing |
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Article Synopsis
- The study focused on cytomegalovirus end-organ disease (CMV-EOD) in critically ill, immunocompromised patients across 18 ICUs in France, Israel, and Spain, analyzing clinical characteristics and patient outcomes from January 2010 to December 2021.
- A total of 185 patients were examined, with pneumonia being the most common form of CMV-EOD, affecting 62.2%, followed by gastrointestinal disease; the overall hospital mortality rate was strikingly high at 61.4%.
- Key factors linked to increased mortality included having hematologic malignancies, particularly with active graft-versus-host disease, experiencing CMV pneumonia, and low lymphocyte counts