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04-03-2024 | Epstein-Barr Virus | Original

Reactivation of Epstein–Barr virus among intensive care patients: a prospective observational study

Authors: François Guiouillier, Jean Derely, Alexandre Salvadori, Jonas Pochard, Jérôme Le Goff, Thibault Martinez, Florent Raffin, Philippe Laitselart, Charlotte Beaucreux, Sonia Priou, Pierre-Louis Conan, Vincent Foissaud, Aurélie Servonnet, Philippe Vest, Mathieu Boutonnet, Stéphane de Rudnicki, Christine Bigaillon, Nicolas Libert

Published in: Intensive Care Medicine | Issue 3/2024

Abstract

Purpose

Herpesvirus reactivation has been documented among patients in the intensive care unit (ICU) and is associated with increased morbidity and mortality, particularly for cytomegalovirus (CMV). Epstein–Barr virus (EBV) has been poorly studied despite >95% of the population being seropositive. Our preliminary study suggested an association between EBV reactivation and increased morbidity and mortality. This study aimed to investigate this association among patients admitted to the ICU.

Methods

In this multicenter prospective study, polymerase chain reaction was performed to quantify EBV in patients upon ICU admission and then twice a week during their stay. Follow-up was 90 days.

Results

The study included 129 patients; 70 (54.3%) had EBV reactivation. On day 90, there was no difference in mortality rates between patients with and without reactivation (25.7% vs 15.3%, p = 0.22). Patients with EBV reactivation at admission had increased mortality compared with those without reactivation and those with later reactivation. EBV reactivation was associated with increased morbidity. Patients with EBV reactivation had fewer ventilator-free days at day 28 than those without reactivation (18 [1–22] vs. 21 days [5–26], p = 0.037) and a higher incidence of acute respiratory distress syndrome (34.3% vs. 17%, p = 0.04), infections (92.9% vs. 78%, p = 0.03), and septic shock (58.6% vs. 32.2%, p = 0.004). More patients with EBV reactivation required renal replacement therapy (30% vs. 11.9%, p = 0.02). EBV reactivation was also associated with a more inflammatory immune profile.

Conclusion

While EBV reactivation was not associated with increased 90-day mortality, it was associated with significantly increased morbidity.

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Title: Reactivation of Epstein–Barr virus among intensive care patients: a prospective observational study
Authors: François Guiouillier
Jean Derely
Alexandre Salvadori
Jonas Pochard
Jérôme Le Goff
Thibault Martinez
Florent Raffin
Philippe Laitselart
Charlotte Beaucreux
Sonia Priou
Pierre-Louis Conan
Vincent Foissaud
Aurélie Servonnet
Philippe Vest
Mathieu Boutonnet
Stéphane de Rudnicki
Christine Bigaillon
Nicolas Libert
Publication date: 04-03-2024
Publisher: Springer Berlin Heidelberg
Keywords: Epstein-Barr Virus
Herpes Virus
Septic Shock
Published in: Intensive Care Medicine / Issue 3/2024
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-024-07345-3

At a glance: The STEP trials

Springer Medicine

Reactivation of Epstein–Barr virus among intensive care patients: a prospective observational study

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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