مقايسه فراواني عفونت هاي ويروسي هپاتيت B، هپاتيت C، HIV، اپشتين بار و سايتومگالوويروس در بيماران مبتلا به لوپوس و جمعيت سالم

Comparison of the prevalence of HBV, HCV, HIV, CMV and EBV infections in patients with systemic lupus erythromatosus and healthy population

لوپوس بيماري خودايمني سيستميك است كه تقريبا تمام ارگان هاي بدن را درگير مي كند و عفونت هاي ويروسي در آغاز و يا پيشرفت آن دخالت دارند. اين مطالعه با هدف بررسي وضعيت سرولوژيكي برخي از عفونت هاي ويروسي در بيماران مبتلا به لوپوس و جمعيت سالم انجام شده است. روش بررسي اين مطالعه توصيفي از خرداد 1396 تا ارديبهشت 1397 در مركز تحقيقات ايدز دانشگاه علوم پزشكي شيراز روي 70 بيمار مبتلا به لوپوس و 70 فرد سالم كه به هيچ نوع بيماري خودايمني مبتلا نبوده و از نظر جنسيت و سن با گروه بيماران تطبيق داده شده بودند انجام گرديد. نمونه هاي پلاسما با استفاده از كيت هاي اليزا از نظر وجود آنتي ژن سطحي ويروس هپاتيت B (HBsAg)، آنتي بادي ضد ويروس هپاتيت C (HCVAb)، آنتي بادي ضدويروس اچ آي وي (HIVAb)، ايمونوگلوبولين G ضد آنتي ژن كپسيد ويروس اپشتين بار (EBV-VCA-IgG) و ايمونوگلوبولين G ﺿﺪ ﺳﺎﯾﺘﻮﻣﮕﺎﻟﻮوﯾﺮوس )CMV-IgG( ﺑﺮرﺳﯽ ﺷﺪﻧﺪ. ﯾﺎﻓﺘﻪﻫﺎ: ﻣﻮارد ﻣﺜﺒﺖ ﺳﺮوﻟﻮژﯾﮑﯽ CMV-IgG و EBV-VCA-IgG در ﮔﺮوه ﺑﯿﻤــﺎران ﻟﻮﭘــﻮس ﺑــﻪﺗﺮﺗﯿﺐ 70 )100%( و 65 )92/9%( و در ﮔﺮوه اﻓﺮاد ﺳﺎﻟﻢ 68 )97/1%( و 57 )81/4%( ﺑــﻮد. ﻓﺮاواﻧــﯽ EBV-VCA-IgG در ﮔــﺮوه ﺑﯿﻤــﺎران ﻟﻮﭘــﻮس ﺑﻪﻃﻮر ﻣﻌﻨﺎداري ﺑﯿﺸﺘﺮ از اﻓﺮاد ﺳﺎﻟﻢ ﺑﻮد )0.043=P(. ﻣﯿﺰان ﺟــﺬب ﻧــﻮري CMV-IgG و EBV-VCA-IgG در ﻧﻤﻮﻧــﻪﻫﺎي ﺑﯿﻤﺎران ﻧﺴﺒﺖ ﺑﻪ ﮔﺮوه ﮐﻨﺘﺮل ﺑﻪﻃﻮر ﻣﻌﻨﺎداري ﺑﺎﻻﺗﺮ ﺑﻮد )0/0001

Systemic lupus erythematosus is a systemic autoimmune disease that affects almost all organs of the body, and viral infections are involved in its development and progression. The present study aimed to evaluate the serological status of some viral infections in patients with systemic lupus erythematosus and a healthy population. Methods This descriptive study conducted from May 2017 to April 2018 at Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran on 70 patients with systemic lupus erythematosus and 70 healthy individuals who had no autoimmune diseases and were matched with the patient group for age and sex. All patients had active records and were routinely visited in rheumatology clinic of Hafez hospital, affiliated with Shiraz University of Medical Sciences. The evidence of active disease was assessed by the physicians of this practice according to the American College of Rheumatology criteria. Peripheral blood samples were collected in tubes containing EDTA and centrifuged at 3000 rpm for 5 min. The plasma of study participants was evaluated for HBsAg, HCVAb, HIVAb, EBV-VCA-IgG, and CMV-IgG using a commercially available ELISA kit. Results The seropositivity of CMV-IgG and EBV-VCA-IgG in the systemic lupus erythematosus group was 70 (100%) and 65 (92.9%), and in healthy individuals was 68 (97.1%) and 57 (81.4%), respectively. The prevalence of EBV-VCA-IgG in the systemic lupus erythematosus group was significantly higher than healthy ones (P=0.043). The optical density (OD) of CMV-IgG and EBV-VCA-IgG in patients with systemic lupus erythematosus was significantly higher than in healthy individuals (P<0.0001). All patients with systemic lupus erythematosus were negative for HBsAg and HIVAb, but HCVAb was detected in 1 (1.4%) patient. Conclusion Considering the higher frequency of EBV-VCA-IgG and the higher titer of antibodies against CMV and EBV in patient groups compared to healthy individuals group, it seems that periodical assessment of viral load in patients with systemic lupus erythematosus will be beneficial to prescribe medication by physicians if it is needed.