Étude comparative des primo-infections à Epstein-Barr virus et à cytomégalovirus chez 52 patients immunocompétents

Abstract

Objective The objective of this study was to compare epidemiological, clinical, and biological data of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) primary infections in immunocompetent adults, admitted in the infectious disease department of the Reims Teaching Hospital between 2000 and 2005. Patients and methods Inclusion criteria were the presence of anti-VCA IgM antibodies or the presence of CMV specific IgM antibodies and the absence of any other positive serology. Differences in reported percentage were compared with a Khi 2 test or Fischer's exact test, when appropriate. Continuous variables were compared with the Mann-Whitney Test. Results There were no significant changes over the years in the numbers of EBV ( n = 32) and CMV ( n = 20) primary infections. The patient's mean age was 22.7 years (14–48 years) in EBV primary infections and 38.6 years (13–66 years) in CMV primary infections ( P < 0.01). The clinical variables significantly associated with primary EBV infection were sore throat and cervical lymphadenopathy ( P < 0.01). Arthromyalgia and respiratory manifestations were less frequent in EBV primary infection ( P < 0.01). The biological variables significantly associated with EBV primary infection were a marked alanine aminotransferase elevation and a marked lymphocytosis with atypical lymphocytes ( P < 0.001). Thrombopenia was less frequently associated with EBV primary infection ( P < 0.001). Conclusion Clinical and biological presentations of EBV and CMV primary infections were similar. The simultaneous serologic diagnosis of these two infections remains necessary to provide a specific diagnosis, for the most efficient patient care.