Cytomegalovirus infection is a risk factor for venous thromboembolism in ANCA-associated vasculitis
King, C Patel, R Mendoza, C Walker, J K Wu, E Y Moss, P Morgan, M D O'Dell Bunch, D Harper, L Chanouzas, D
King, C
Patel, R
Mendoza, C
Walker, J K
Wu, E Y
Moss, P
Morgan, M D
O'Dell Bunch, D
Harper, L
Chanouzas, D
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2022-08-10
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Abstract
Background
Venous thromboembolism (VTE) is a common complication in patients with anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV) and confers significant morbidity and mortality. Both acute and past cytomegalovirus (CMV) infection have been identified as risk factors for VTE in immunocompetent and immunosuppressed individuals. Here, we examine whether past exposure to CMV is a risk factor for VTE amongst patients with AAV.
Methods
We retrospectively analysed outcomes of patients with a new diagnosis of AAV from a UK cohort. All confirmed cases of VTE where CMV IgG serology was available were recorded. Retrospective collection of the same data for patients at a North American centre was used as a validation cohort.
Results
VTE was common with 12% of patients from the study cohort (total 259 patients) developing an event during the median follow-up period of 8.5 years of which 60% occurred within the first 12 months following diagnosis. Sixteen percent of CMV seropositive patients developed a VTE compared with 5% of patients who were seronegative (p = 0.007) and CMV seropositivity remained an independent predictor of VTE in multivariable analysis (HR 2.96 [1.094–8.011] p = 0.033). CMV seropositivity at diagnosis was confirmed as a significant risk factor for VTE in the American validation cohort (p = 0.032).
Conclusions
VTE is common in patients with AAV, especially within the first year of diagnosis. Past infection with CMV is an independent risk factor associated with VTE in AAV.
Citation
King C, Patel R, Mendoza C, Walker JK, Wu EY, Moss P, Morgan MD, O'Dell Bunch D, Harper L, Chanouzas D. Cytomegalovirus infection is a risk factor for venous thromboembolism in ANCA-associated vasculitis. Arthritis Res Ther. 2022 Aug 10;24(1):192. doi: 10.1186/s13075-022-02879-7.
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Article