Human Cytomegalovirus Infection in Patients with Autoimmune Bullous Disease

Abstract

This study retrospectively examined 88 patients with autoimmune bullous diseases who underwent cytomegalovirus (CMV) pp65 antigen testing during induction therapy. CMV antigen-positive cells were detected in 52 (59%) patients. Even after June 2016, when testing was conducted for all but one case, the reactivation rate remained high at 58% (34/59 cases). CMV reactivation was more common in older patients aged≥65 years, patients with high initial doses of steroids, patients with lower body mass indices (BMI), and patients with low lymphocyte counts and/or elevated neutrophil-to-lymphocyte ratios at 2 weeks after hospitalization. There was no significant difference in mortality between patients with and without CMV reactivation. In autoimmune bullous diseases, risk-based surveillance for CMV reactivation and appropriate intervention may help prevent deterioration of survival outcomes.