CMV Reactivation Common During High-Dose Glucocorticoid Induction
Risk factors for CMV infection among adults with RMDs included diabetes, prior malignancy, IV cyclophosphamide, and initial prednisolone >0.91 mg/kg/day.
Among a cohort of hospitalized adults receiving remission-induction with high-dose glucocorticoids for rheumatic musculoskeletal diseases, cytomegalovirus (CMV) infection was observed among 33.1% — exclusively affecting immunoglobulin (Ig) G-positive patients.
Latent CMV can reactivate under immunosuppression, leading to clinically significant disease. Prior estimates of CMV incidence in intensively treated rheumatic populations range from 31% to 50%.
Most studies have been retrospective, leaving real-world management, especially pre-emptive antiviral use, uncertain.
According to study results published in Clinical Rheumatology.
Author summary: High-dose glucocorticoids increase CMV reactivation risk.