Abstract
Cytomegalovirus (CMV) is a common human beta-herpes virus most notable for causing visceral disease in profoundly immune-suppressed populations, and congenital infections. However, an increasing body of work has demonstrated that CMV seropositivity is associated with a number of chronic medical conditions including heart disease and dementia – potentially related to the effects of chronic inflammation. We hypothesided that the outcomes of individuals with cystic fibrosis (CF), a chronic inflammatory disease, could similarly be associated with CMV-status. We performed a single-centre retrospective study of all 71 individuals with CF referred for lung transplantation from our CF centre between 1991–2017 and assessed how CMV serostatus associated with patient pre-transplant outcomes. We observed CMV IgG positivity was associated with disproportionate progression to end-stage lung disease as defined by death/or transplantation in our cohort (27.2 versus 35.1 years, difference 7.95 (95% CI 3.61–12.29 years), p<0.001) which remained significant following adjustment for confounders (difference 6.96 (95% CI 2.51–11.41 years). CMV may represent a potentially important modifier of CF lung disease, warranting further study.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Parkins reports grants from CF Canada, grants from CIHR Canada, grants from Gilead Sciences, grants from Alberta & NWT Lung Association, outside the submitted work.
Conflict of interest: Dr. Ramos reports grants from National Institutes of Health, grants from Cystic Fibrosis Foundation, grants from CHEST Foundation, outside the submitted work.
Conflict of interest: Dr. Goss reports grants from Cystic Fibrosis Foundation, grants from European Commission, grants from NIH (NHLBI), grants from NIH (NIDDK and NCRR), during the conduct of the study; personal fees from Gilead Sciences, personal fees from Novartis, grants from NIH, grants from FDA, other from Boehringer Ingelheim, outside the submitted work.
Conflict of interest: Dr. Somayaji reports grants from CF Canada, grants from CIHR Canada, grants from Alberta Innovates, outside the submitted work.
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