Effect of cytomegalovirus reactivation on the time course of systemic host response biomarkers in previously immunocompetent critically ill patients with sepsis: A matched cohort study 11 Medical and Health Sciences 1103 Clinical Sciences

Kirsten Van De Groep, Stefan Nierkens, Olaf L. Cremer, Linda M. Peelen, Peter M.C. Klein Klouwenberg, Marcus J. Schultz, C. Erik Hack, Tom Van Der Poll, Marc J.M. Bonten, David S.Y. Ong, Friso M. De Beer, Lieuwe D.J. Bos, Gerie J. Glas, Arie J. Hoogendijk, Roosmarijn T.M. Van Hooijdonk, Janneke Horn, Mischa A. Huson, Nicole P. Juffermans, Laura R.A. Schouten, Brendon SciclunaMarleen Straat, Lonneke A. Van Vught, Luuk Wieske, Maryse A. Wiewel, Esther Witteveen, Jos F. Frencken, K. Van De Groep, Maria E. Koster-Brouwer, Meri R.J. Varkila, Diana M. Verboom

Onderzoeksoutput: Bijdrage aan tijdschriftArtikelpeer review

9 Citaten (Scopus)

Samenvatting

Background: Cytomegalovirus (CMV) reactivation in previously immunocompetent critically ill patients is associated with increased mortality, which has been hypothesized to result from virus-induced immunomodulation. Therefore, we studied the effects of CMV reactivation on the temporal course of host response biomarkers in patients with sepsis. Methods: In this matched cohort study, each sepsis patient developing CMV reactivation between day 3 and 17 (CMV+) was compared with one CMV seropositive patient without reactivation (CMVs+) and one CMV seronegative patient (CMVs-). CMV serostatus and plasma loads were determined by enzyme-linked immunoassays and real-time polymerase chain reaction, respectively. Systemic interleukin-6 (IL-6), IL-8, IL-18, interferon-gamma-induced protein-10 (IP-10), neutrophilic elastase, IL-1 receptor antagonist (RA), and IL-10 were measured at five time points by multiplex immunoassay. The effects of CMV reactivation on sequential concentrations of these biomarkers were assessed in multivariable mixed models. Results: Among 64 CMV+ patients, 45 could be matched to CMVs+ or CMVs- controls or both. The two baseline characteristics and host response biomarker levels at viremia onset were similar between groups. CMV+ patients had increased IP-10 on day 7 after viremia onset (symmetric percentage difference +44% versus -15% when compared with CMVs+ and +37% versus +4% when compared with CMVs-) and decreased IL-1RA (-41% versus 0% and -49% versus +10%, respectively). However, multivariable analyses did not show an independent association between CMV reactivation and time trends of IL-6, IP-10, IL-10, or IL-1RA. Conclusion: CMV reactivation was not independently associated with changes in the temporal trends of host response biomarkers in comparison with non-reactivating patients. Therefore, these markers should not be used as surrogate clinical endpoints for interventional studies evaluating anti-CMV therapy.

Originele taal-2Engels
Artikelnummer348
TijdschriftCritical Care
Volume22
Nummer van het tijdschrift1
DOI's
StatusGepubliceerd - 18 dec. 2018
Extern gepubliceerdJa

Vingerafdruk

Duik in de onderzoeksthema's van 'Effect of cytomegalovirus reactivation on the time course of systemic host response biomarkers in previously immunocompetent critically ill patients with sepsis: A matched cohort study 11 Medical and Health Sciences 1103 Clinical Sciences'. Samen vormen ze een unieke vingerafdruk.

Citeer dit