Association Of Epstein-barr Virus And Human Cytomegalovirus Infection With Lupus-related Pleuropulmonary Involvement

[Objective] To prove EB virus (EBV) and human cytomegalovirus (HCMV) as acausative factor for lupus-related Pleuropulmonary involvement，especially the acutediffuse exudative lung disease. And to evaluate the clinical efficacy of antiviraltherapy for acute diffuse exudative lung disease in SLE.[Method] ELISA was used to detect EBV-IgA, IgM,IgG and indirectchemiluminescence immunoassay (CLIA) to detect HCMV-IgM, IgG for97lupus-related pleuropulmonary involvement patients and106SLE withoutPleuropulmonary involvement patients.Polymerase chain reaction (PCR) was used toamplify EBV and HCMV-DNA for71lupus-related pleuropulmonary involvementpatients and70SLE without pleuropulmonary involvement patients.[Results]1、 Serum HCMV-IgM antibody positive rate was20.6%in lupus-relatedpleuropulmonary involvement group, significantly higher than SLE withoutpleuropulmonary involvement group(10.6%), χ2=4.11，P=0.043.2、 The PCR positive rates of EBV-DNA and HCMV-DNA were53.5%inlupus-related pleuropulmonary involvement group,significantly higher than SLEwithout pleuropulmonary involvement group (35.7%), χ2=4.52, P=0.033.3、In lupus-related pleuropulmonary involvement group,the patients with recent EBVor HCMV infection have significantly higher rate of skin lesions (χ2=4.1, P=0.043);significantly lower complement C4levels (t=2.76, P=0.007); significantly higherpositive rate of CRP；and erythrocyte sedimentation rate increased significantly (t=-2.99, P=0.004); SLEDAI score increased significantly (t=-4.24, P <0.0001).4、In lupus-related pleuropulmonary involvement group,HCMV-DNA positive ratewas41.7%in SLE with acute diffuse exudative lung disease, significantly higher thanthe other lupus-related pleuropulmonary involvement patients (6.8%),χ2=8.53, P=0.004.5、At end points,81.8%(9/11) patients got better in anti-viral therapy group. And5patients pulmonary inflammation absorbed completely,4patients progress to chronicinterstitial pneumonia. only33.3%(2/6) got better in no anti-viral therapy group, andthe two patients progress to interstitial pneumonia. [Conclusion]1、EBV and HCMV infection were associated with lupus-related pleuropulmonaryinvolvement.And HCMV infection was closely associated with the acute diffuseexudative lung disease in SLE.2、Confirming the efficacy of anti-virus therapy to acute diffuse exudative lungdisease in SLE.