Frequency of cytomegalovirus and Epstein–Barr infections, and their combination in patients with systemic lupus erythematosus depending on the duration of the disease and the degree of its activity

Abstract

Annotation. Systemic lupus erythematosus (SLE) is a chronic disease characterized by a variety of clinical manifestations with phases of exacerbation and remission, which often complicate the clinician in determining treatment tactics or possible impact on its course of comorbid lesions, including those caused by viral infection. It is known that more than 90.0 % of patients with SLE are infected with cytomegalovirus (CMV) and about 99.5 % with Epstein–Barr virus (EBV). Because CMV and EBV can persist in the human body, more and more attention is being paid to elucidating the effects of active viral infection on the course and activity of SLE, the main pathogenetic mechanism of which is the autoimmune process. The aim of the study was to establish the frequency of cytomegalovirus and Epstein–Barr infections, and their combination in patients with systemic lupus erythematosus depending on the duration of the disease and the degree of its activity. The study involved 120 patients with SLE aged 18 to 69 years, who were in the rheumatology department of the Communal Non-Profit Enterprise of the Lviv Regional Council “Lviv Regional Clinical Hospital” in 2014–2019. To diagnose CMV and EBV infection, antibodies of immunoglobulins M and immunoglobulins G to viruses were detected in blood serum, as well as viruses were detected with polymerase chain reaction and groups of patients were formed: patients with active CMV infection; active EBV; active CMV and EBV; without active CMV and EBV. To achieve the goal, the study was conducted in two stages: determining the frequency of CMV and EBV infection and their combination depending on the duration of SLE (first) and the degree of its activity (second). Statistical analysis was performed in MS Excel using descriptive statistics, Student's t-test to compare samples with normal distribution, χ2-test, z-test to compare two particles; statistically significant relationship was considered when p<0.05. According to our results, active CMV infection is more common in patients with systemic lupus erythematosus duration less than 1 year, active EBV infection – in patients with disease duration greater than 10 years, a combination of active CMV and EBV infection – in patients with systemic lupus erythematosus duration less than 1 year. The increase in the degree of activity of systemic lupus erythematosus is accompanied by a significant (p<0.05) increase in the incidence of active CMV and EBV infection, as well as an increase in mean IgM and IgG antibody titers to these viruses in patients with increasing disease activity.