Cytomegalovirus infection is a risk factor for venous thromboembolism in ANCA-associated vasculitis.
Cytomegalovirus infection is a risk factor for venous thromboembolism in ANCA-associated vasculitis.
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DOI：
10.1186/s13075-022-02879-7
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发表时间：
2022-08-10
影响因子：
4.9
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中科院分区：
文献类型：
--
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静脉血栓栓塞（VTE）是抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AV）患者的常见并发症，并导致显着的发病率和死亡率。急性和既往巨细胞病毒（CMV）感染已被确定为免疫功能正常和免疫抑制个体发生VTE的危险因素。在这里，我们研究是否过去暴露于CMV是一个危险因素与AAV患者之间的静脉血栓栓塞。我们回顾性分析了来自英国队列的新诊断为AAV的患者的结局。记录所有CMV IgG血清学可用的VTE确诊病例。回顾性收集北美中心患者的相同数据作为验证队列。VTE很常见，研究队列中12%的患者（共259例患者）在8.5年的中位随访期内发生事件，其中60%发生在诊断后的前12个月内。16%的CMV血清阳性患者发生VTE，而血清阴性患者发生VTE的比例为5%（p = 0.007），在多变量分析中，CMV血清阳性仍然是VTE的独立预测因素（HR 2.96 [1.094-8.011] p = 0.033）。在美国验证队列中，诊断时CMV血清阳性被证实为VTE的显著风险因素（p = 0.032）。VTE在AAV患者中很常见，尤其是在诊断的第一年内。既往CMV感染是与AAV患者VTE相关的独立危险因素。在线版本包含补充材料，可通过10.1186/s13075-022-02879-7获得。
Venous thromboembolism (VTE) is a common complication in patients with anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV) and confers significant morbidity and mortality. Both acute and past cytomegalovirus (CMV) infection have been identified as risk factors for VTE in immunocompetent and immunosuppressed individuals. Here, we examine whether past exposure to CMV is a risk factor for VTE amongst patients with AAV. We retrospectively analysed outcomes of patients with a new diagnosis of AAV from a UK cohort. All confirmed cases of VTE where CMV IgG serology was available were recorded. Retrospective collection of the same data for patients at a North American centre was used as a validation cohort. VTE was common with 12% of patients from the study cohort (total 259 patients) developing an event during the median follow-up period of 8.5 years of which 60% occurred within the first 12 months following diagnosis. Sixteen percent of CMV seropositive patients developed a VTE compared with 5% of patients who were seronegative (p = 0.007) and CMV seropositivity remained an independent predictor of VTE in multivariable analysis (HR 2.96 [1.094–8.011] p = 0.033). CMV seropositivity at diagnosis was confirmed as a significant risk factor for VTE in the American validation cohort (p = 0.032). VTE is common in patients with AAV, especially within the first year of diagnosis. Past infection with CMV is an independent risk factor associated with VTE in AAV. The online version contains supplementary material available at 10.1186/s13075-022-02879-7.
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