Abstract

BackgroundHuman herpesviruses (HHVs) are responsible for a significant number of clinical manifestations in systemic lupus erythematous (SLE) patients. The aim of this study was to determine the frequency of active HHV infections in SLE patients and correlating them with disease activity.MethodsSerum samples were collected from 71 SLE patients and their DNAs were extracted and analyzed to detect HHV-DNA viruses using the nucleic acid amplification technique.ResultsFifteen out of the 71 (21.1%) patients tested positive for the HHV-DNA virus. Of them, 11/15 HHV-DNA-positive patients (73.3%) had SLE activity index (SLEDAI – Systemic Lupus Erythematosus Disease Activity Index) ≥8 (p = 0.0001). Active HCMV infection was the mostly frequently observed infection, occurring in 6/15 patients (40%). The frequencies of other active viral infections were 22% for HSV-1, 16.7% for HHV-7, and 5.5% for HSV-2. Viral coinfection (two or more viruses detected in the same sample) occurred in three patients (16.7%). Active HHV infections in SLE patients are more frequent in those with active SLE (≥8), who is at high risk of HHV reactivation and HCMV disease.ConclusionViral surveillance is important to identify active HHV infections that can cause clinical symptoms and other complication in SLE patients.

Highlights

  • Herpesvirus (HHV) infections in patients with systemic lupus erythematosus (SLE) are an important cause of morbidity and mortality [1,2,3,4,5,6]

  • Human herpesvirus 8 (HHV-8) is mainly associated with Kaposi’s sarcoma, one of the neoplasms that is most frequently encountered in HIV-infected patients [13]

  • All data were collected from clinical reports stored in the medical clinical reports service of the Clinical Hospital of the State University of Campinas to evaluate their correlation with positive Human herpesviruses (HHVs)-DNA, e.g., Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), hospitalization and symptoms, allowing the inference of a diagnostic status

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Summary

Introduction

Herpesvirus (HHV) infections in patients with systemic lupus erythematosus (SLE) are an important cause of morbidity and mortality [1,2,3,4,5,6]. Few studies have evaluated the impact of HHV infections on patients with SLE, infection remains as the main cause of death, mostly due to their immunosuppressive therapy (i.e., steroids, such as prednisone) and abnormal immune response [14, 15]. This transversal study was undertaken to determine the frequency of HHV infections in patients with SLE using the Nested PCR (NPCR) technique, and to evaluate the laboratorial findings with disease activity. The aim of this study was to determine the frequency of active HHV infections in SLE patients and correlating them with disease activity

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