Reactivation of Latent Cytomegalovirus Infection after Major Surgery: Risk Factors and Outcomes

Gardiner, Bradley J.; Herrick, Katherine; Bailey, Rosemary; Chow, Jennifer; Snydman, David R.

doi:10.1089/sur.2018.245

Cited by 6 publications

(4 citation statements)

References 31 publications

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“…The association between recipient age and CMV‐DNAemia has already been described by other groups 13,14 . Additionally, the association with a prolonged and complicated postoperative course in these patients, who are more complex and are likely to be critically ill, due to reactivation of CMV, also seems very likely 15–17 . The constellation of D+/R− CMV IgG is considered an important risk factor for postoperative CMV‐DNAemia 6,7,11,18 .…”

Section: Discussionmentioning

confidence: 69%

“…13,14 Additionally, the association with a prolonged and complicated postoperative course in these patients, who are more complex and are likely to be critically ill, due to reactivation of CMV, also seems very likely. [15][16][17] The constellation of D+/R− CMV IgG is considered an important risk factor for postoperative CMV-DNAemia. 6,7,11,18 Consequently, we could confirm a numerical increase in the incidence of D+/R− CMV IgG serology in the CMV group.…”

Section: D+/r− and D−/r+ CMV Igg Serology Are Confirmed Risk Factors ...mentioning

confidence: 99%

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Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation

Immohr,

Oehler,

Jenkins

et al. 2023

Immunity Inflam & Disease

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BackgroundCytomegalovirus (CMV) infections after heart transplantation (HTx) can cause cardiac allograft vasculopathy. Consequently, monitoring and prophylaxis for cytomegalovirus deoxyribonucleic acid (CMV‐DNAemia) within the first weeks after HTx is recommended.MethodsAll patients who underwent HTx between September 2010 and 2021 surviving the first 90 days (n = 196) were retrospectively reviewed. The patients were divided on the prevalence of CMV‐DNAemia during the first postoperative year after the end of the prophylaxis. A total of n = 35 (20.1%) developed CMV‐DNAemia (CMV group) and were compared to patients without CMV‐DNAemia (controls, n = 139). The remaining patients (n = 22) were excluded due to incomplete data.ResultsPositive donors and negative recipients (D+/R−) and negative donors and positive recipients (D−/R+) serology was significantly increased and D−/R− decreased in the CMV group (p < .01). Furthermore, the mean age was 57.7 ± 8.7 years but only 53.6 ± 10.0 years for controls (p = .03). Additionally, the intensive care unit (p = .02) and total hospital stay (p = .03) after HTx were approximately 50% longer. Interestingly, the incidence of CMV‐DNAemia during prophylaxis was only numerically increased in the CMV group (5.7%, respectively, 0.7%, p = .10), the same effect was also observed for postoperative infections. Multivariate analyses confirmed that D+/R− and D−/R+ CMV immunoglobulin G match were independent risk factors for postprophylaxis CMV‐DNAemia.ConclusionOur data should raise awareness of CMV‐DNAemia after the termination of regular prophylaxis, as this affects one in five HTx patients. Especially old recipients as well as D+/R− and D−/R+ serology share an elevated risk of late CMV‐DNAemia. For these patients, prolongation, or repetition of CMV prophylaxis, including antiviral drugs and CMV immunoglobulins, may be considered.

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Section: Discussionmentioning

confidence: 69%

Section: D+/r− and D−/r+ CMV Igg Serology Are Confirmed Risk Factors ...mentioning

confidence: 99%

Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation

Immohr,

Oehler,

Jenkins

et al. 2023

Immunity Inflam & Disease

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“…Immunocompromised patients with a severe form of the disease and multiple organ involvement have a high risk of morbidity and mortality. In those cases, the reactivation of CMV infection is very common [ 16 , 17 ].…”

Section: Resultsmentioning

confidence: 99%

An Overview of Cytomegalovirus Infection in Pregnancy

et al. 2022

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The objective of this review was to bring to attention cytomegalovirus (CMV) infection during pregnancy, taking into consideration all relevant aspects, such as maternal diagnosis, fetal infection and prevention, prenatal diagnosis, and postnatal prognosis. A literature review was performed regarding adult and congenital infection. General information regarding this viral infection and potential related medical conditions was provided, considering the issues of maternal infection during pregnancy, transmission to the fetus, and associated congenital infection management. Prenatal diagnosis includes maternal serum testing and the confirmation of the infection in amniotic fluid or fetal blood. Additionally, prenatal diagnosis requires imaging techniques, ultrasound, and complementary magnetic resonance to assess cortical and extracortical anomalies. Imaging findings can predict both fetal involvement and the postnatal prognosis of the newborn, but they are difficult to assess, even for highly trained physicians. In regard to fetal sequelae, the early diagnosis of a potential fetal infection is crucial, and methods to decrease fetal involvement should be considered. Postnatal evaluation is also important, because many newborns may be asymptomatic and clinical anomalies can be diagnosed when sequelae are permanent.

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“…However, we did not detect HSV-1/2-infections, but found twice as many infections with other herpesviruses HCMV and EBV in PCa as in BPH. Reactivation of HCMV may occur in previously immunocompetent patients post-operatively after chemo- or radiotherapy, and is associated with poor outcomes, including other infections and mortality [ 53 ]. Zinc is an essential trace element crucial for immune function, can influence antiviral immunity, and is discussed as possibly favorable additive against viral infections such as HSV and the common cold [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Tracing TET1 expression in prostate cancer: discovery of malignant cells with a distinct oncogenic signature

et al. 2021

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Background Ten–eleven translocation methylcytosine dioxygenase 1 (TET1) is involved in DNA demethylation and transcriptional regulation, plays a key role in the maintenance of stem cell pluripotency, and is dysregulated in malignant cells. The identification of cancer stem cells (CSCs) driving tumor growth and metastasis is the primary objective of biomarker discovery in aggressive prostate cancer (PCa). In this context, we analyzed TET1 expression in PCa. Methods A large-scale immunohistochemical analysis of TET1 was performed in normal prostate (NOR) and PCa using conventional slides (50 PCa specimens) and tissue microarrays (669 NOR and 1371 PCa tissue cores from 371 PCa specimens). Western blotting, RT-qPCR, and 450 K methylation array analyses were performed on PCa cell lines. Genome-wide correlation, gene regulatory network, and functional genomics studies were performed using publicly available data sources and bioinformatics tools. Results In NOR, TET1 was exclusively expressed in normal cytokeratin 903 (CK903)–positive basal cells. In PCa, TET1 was frequently detected in alpha-methylacyl-CoA racemase (AMACR)–positive tumor cell clusters and was detectable at all tumor stages and Gleason scores. Pearson’s correlation analyses of PCa revealed 626 TET1-coactivated genes (r > 0.5) primarily encoding chromatin remodeling and mitotic factors. Moreover, signaling pathways regulating antiviral processes (62 zinc finger, ZNF, antiviral proteins) and the pluripotency of stem cells were activated. A significant proportion of detected genes exhibited TET1-correlated promoter hypomethylation. There were 161 genes encoding transcription factors (TFs), of which 133 were ZNF-TFs with promoter binding sites in TET1 and in the vast majority of TET1-coactivated genes. Conclusions TET1-expressing cells are an integral part of PCa and may represent CSCs with oncogenic potential.

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Reactivation of Latent Cytomegalovirus Infection after Major Surgery: Risk Factors and Outcomes

Cited by 6 publications

References 31 publications

Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation

Evaluation of risk factors for cytomegalovirus DNAemia after end of regular prophylaxis after heart transplantation

An Overview of Cytomegalovirus Infection in Pregnancy

Tracing TET1 expression in prostate cancer: discovery of malignant cells with a distinct oncogenic signature

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