Community-acquired pneumonia associated with cytomegalovirus persistence: prevalence and peculiarities of clinical course

Authors

  • K. D. Chichirelo-Konstantynovych National Pirogov Memorial Medical University, Vinnytsia, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2018.3.132125

Keywords:

cytomegalovirus, pneumonia, PORT, antibodies

Abstract

The article discusses the problem of cytomegaloviral persistence asymptomatic course among young patients with community-acquired pneumonia and in healthy population group based on specific immunoglobulins M and G appearance in blood and antibody avidity value (the duration of persistent). The connection between viral persistence and prognosis of community-acquired pneumonia course (by pneumonia severity index in PORT) is also recognized.

Aim of the scientific work is to study the prevalence of cytomegaloviral persistence among young patients with community-acquired pneumonia for optimization the plan of clinical examination and prognosis for this patient category.

Materials and methods. One hundred and five patients with community-acquired pneumonia and 61 healthy individuals (aged from 18 to 44 years) were examined for cytomegaloviral biomarkers (CMV IgG, CMV IgG avidity) and by PORT-scale. Positive result for viral persistence was compared with gender, age subtypes and pneumonia severity index in both groups.

Results. Cytomegaloviral persistence prevalence rate among patients with community-acquired pneumonia was 48.2 % versus 20.5 % among healthy individuals (p = 0.003). The patients with community-acquired pneumonia had higher CMV IgG avidity value (p = 0.007), it was more common for female patients (P = 0.043; χ2 = 8.164). The cytomegaloviral persistence prevalence increased with age (P = 0,045) and correlated with pneumonia severity index according to PORT-scale (P < 0.0001).

Conclusions. The patients with community-acquired pneumonia differ in significantly higher cytomegaloviral prevalence rate (P = 0.003) from the healthy respondents. This rate increases with age, negatively impacts the pneumonia prognosis (by PORT-score). The duration of cytomegaloviral persistence (based on the CMV IgG avidity value recognition) does not depend on age in both comparison groups (P > 0.05).

References

Bao, L., Cowan, M., Dunham, K., Horn, B., McGuirk, J., Gilman, A., & Lucas, K. (2012). Adoptive Immunotherapy With CMV-specific Cytotoxic T Lymphocytes for Stem Cell Transplant Patients With Refractory CMV Infections. Journal Of Immunotherapy, 35(3), 293–298. doi: 10.1097/CJI.0b013e31824300a2.

Cook, C., Trgovcich, J., Zimmerman, P., Zhang, Y., & Sedmak, D. (2006). Lipopolysaccharide, Tumor Necrosis Factor Alpha, or Interleukin-1 Triggers Reactivation of Latent Cytomegalovirus in Immunocompetent Mice. Journal Of Virology, 80(18), 9151–9158. doi: 10.1128/JVI.00216-06.

Chalmers, J., Singanayagam, A., Akram, A., Mandal, P., Short, P., Choudhury, G., et al. (2010). Severity assessment tools for predicting mortality in hospitalised patients with community-acquired pneumonia. Systematic review and meta-analysis. Thorax, 65(10), 878–883. doi: 10.1136/thx.2009.133280.

Eguchi, H., Horita, N., Ushio, R., Kato, I., Nakajima, Y., Ota, E., & Kaneko, T. (2017). Diagnostic test accuracy of antigenaemia assay for PCR-proven cytomegalovirus infection-systematic review and meta-analysis. Clinical Microbiology And Infection., 23(12), 907–915. doi: 10.1016/j.cmi.2017.05.009.

Feshchenko, Yu. I., Holubovska, O. A., & Honcharov, K. A. (2014). Nehospitalna ta hospitalna (nozokomialna) pnevmoniia u doroslykh osib: etiolohiia, patohenez, klasyfikatsiia, diahnostyka, antybakterialna terapiia [Community-acquired and nosocomial pneumonia in adults: etiology, pathogenesis, classification, diagnostics, antibiotic therapy]. Kyiv. [in Ukrainian].

Goussard, P., Kling, S., Gie, R., Nel, E., Heyns, L., Rossouw, G., & Janson, J. (2010). CMV pneumonia in HIV-infected ventilated infants. Pediatric Pulmonology, 45(7), 650–655. doi: 10.1002/ppul.21228.

Lim, W. S., Baudouin, S. V., George, R. C., Hill, A. T., Jamieson, C., Le Jeune, I., et al. (2009). British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax, 35(3), 293–298. doi: 10.1136/thx.2009.121434.

Palasanthiran, P., Starr, M., & Jones, C. (2014). Management of Perinatal Infections Australian Society for Infectious Diseases, 6–10.

Quan, T., Fawcett, N., Wrightson, J., Finney, J., Wyllie, D., Jeffery, K. et al. (2016). Increasing burden of community-acquired pneumonia leading to hospitalisation, 1998–2014. Thorax, 71(6), 535–542. doi: 10.1136/thoraxjnl-2015-207688.

Reeves, M., & Sinclair, J. (2008). Aspects of human cytomegalovirus latency and reactivation. Curr. Top. Microbiol. Immunol., 325, 297–313. https://doi.org/10.1007/978-3-540-77349-8_17.

Saletinger, R., Poljak, P., & Strle, F. (2015). Presence of human cytomegalovirus DNA in blood of patients with community-acquired pneumonia. Clinical Microbiology and Infection, 21(1), 97–102. doi: 10.1016/j.cmi.2014.09.001.

Tang, L., Li, Q., Bai, J., Zhang, H., Lu, Y., & Ma, S. (2014). Severe Pneumonia Mortality in Elderly Patients Is Associated With Downregulation of Toll-like Receptors 2 and 4 on Monocytes. The American Journal Of The Medical Sciences, 347(1), 34–41. doi: 10.1097/MAJ.0b013e3182798583.

Toussaint, N., Tan, M., Nicholls, K., Walker, R., & Cohney, S. (2011). Low-dose valaciclovir and cytomegalovirus immunoglobulin to prevent cytomegalovirus disease in high-risk renal transplant recipients. Nephrology, 16(1), 113–117. doi: 10.1111/j.1440-1797.2010.01379.x.

Welten, S. P. M., Redeker, A., Toes, R. E. M., & Arens, R. (2016) Viral Persistence Induces Antibody Inflation without Altering Antibody Avidity. Journal of Virology, 90(9), 4402–4411. doi: 10.1128/JVI.03177-15.

Downloads

How to Cite

1.
Chichirelo-Konstantynovych KD. Community-acquired pneumonia associated with cytomegalovirus persistence: prevalence and peculiarities of clinical course. Zaporozhye medical journal [Internet]. 2018May30 [cited 2024Apr.19];(3). Available from: http://zmj.zsmu.edu.ua/article/view/132125

Issue

No. 3 (2018)

Section

Original research

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  Лицензия Creative Commons
    2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
    3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)