AB0723 Seroprevalence of epstein-barr virus and cytomegalovirus in systemic sclerosis patients: preliminary results

Abstract

Background: Epstein‐Barr Virus (EBV) and cytomegalovirus (CMV) are among the most diffused virus in humans, with prevalence of 90% and 80% respectively in adult immunocompetent population 1,2. Hypothesis for a role of EBV and CMV in systemic sclerosis pathogenesis was reported3. Objectives: To evaluate the prevalence of EBV and CMV in a population of patients affected by SSc. As an exploratory aim, correlations with available clinical variables were evaluated. Methods: A total of 49 patients (44 females and 5 males, age 65,6±9 years, 34 with limited cutaneous involvement and 14 with diffused cutaneous involvement) diagnosed according to the 2013 ACR/EULAR criteria 4 were randomly enrolled at their follow‐up visit for a further more detailed analysis. After consent, all participants undergone serological testing for VCA‐IgM, VCA‐IgG and EBNA‐IgG and CMV IgM and IgG, to determine prior or actual EBV and/or CMV infection. All SSc patients undergone also to clinical examination and instrumental evaluations according to SSc clinical standard follow up. Results: Results for EBV seroprevalence were: VCA‐IgM negative=43 (87%), positive=4 (8,2%), borderline=2 (4,1%) in all SSc patients. VCA‐IgG resulted positive in 48 patients (98%) and EBNA‐IgG resulted positive in 40 (81,6%) patients, borderline in 4 (8,2%) and negative in 5 (10,2%) patients. Forty‐six (93,9%) patients resulted positive for CMV‐IgG and 22 (44,9%) showed detectable CMV IgM. Consequently, EBV and CMV seroprevalence was significantly higher (p=0.01 and p=0.032 respectively) than that calculated in general population (90% and 80% respectively). Interestingly, the presence of higher CMV‐IgM correlated linearly with higher pulmonary arterial pressure values (p=0.036) and was different in patients with or without sicca syndrome (p=0.012) and arthralgias (p=0.04). Finally, higher CMV‐IgG correlated with diffused cutaneous SSc form (p=0.023) and nephropathy (p=0.036). Conclusions: The seroprevalence of EBV and CMV positivity was found significantly higher in the sample of SSc patients. EBV seropositivity (VCA‐IgG) was present nearly in the totality of patients (98%). Of relevance, the high presence of CMV‐IgG (93%) and CMV‐IgM (44.9%) in SSc patients: the last correlated linearly with higher pulmonary arterial pressure values. EBV and CMV infections, among the supposed triggers in several autoimmune diseases, might also play a role in SSc patients, at least with progressive disease.