Work

Cytomegalovirus DNAemia in patients with anti-melanoma differentiation-associated gene 5 positive dermatomyositis from southern China

Year: 2026

Type: article

Abstract: BACKGROUND: Cytomegalovirus (CMV) DNAemia represents a significant complication in patients with anti-melanoma differentiation-associated gene 5 positive dermatomyositis (anti-MDA5-positive DM). Here, we aimed to assess the prevalence and risk factors associated with CMV DNAemia in individuals with anti-MDA5-positive DM. Subsequently, we sought to evaluate the impact of CMV DNAemia on the 6-month mortality among these patients. Furthermore, we investigated the independent predictors of mortality in individuals with CMV DNAemia. METHODS: Univariate and multivariate logistic regression analyses were conducted to identify risk factors for the occurrence of CMV DNAemia. Kaplan-Meier curves and the Log Rank-test were employed to compare cumulative survival differences across various subgroups. RESULTS: Among the 237 patients diagnosed with anti-MDA5-positive DM, 76 cases were classified into the CMV DNAemia-positive group, while the remaining 161 patients were categorized as the CMV DNAemia-negative group. Our study revealed that CMV DNAemia was associated with prior exposure to methylprednisolone pulse therapy, median to high doses of glucocorticoids, and the use of biological disease-modifying antirheumatic drugs, as well as increased levels of lactate dehydrogenase. However, there was no significant difference in 6-month mortality between the CMV DNAemia-positive and the CMV DNAemia-negative groups. Furthermore, our findings indicated that patients with CMV DNAemia who presented with rapidly progressive interstitial lung disease (RP-ILD), co-infection with other pathogens, and increased CMV loads exhibited higher 6-month mortality rates compared to those with non-RP-ILD, without co-infection, and with decreased CMV loads, respectively. CONCLUSIONS: CMV DNAemia is prevalent among patients with anti-MDA5-positive DM. However, it does not appear to significantly impact the 6-month mortality of these patients. CMV DNAemia can be effectively managed by identifying potential risk factors, monitoring viral loads dynamically, and initiating preemptive therapy timely.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-026-12762-4