CMV infections affect more than just patients with compromised immune systems, researchers find

July 25, 2008

An infection due to a virus called cytomegalovirus (CMV), which most commonly affects people with compromised immune systems, can also affect hospital intensive-care patients who have no immune-system problems, University of Washington researchers have found. CMV infection is also associated with longer hospital and intensive-care unit (ICU) stays independent of other causes, according to the study, published July 23 in JAMA, the Journal of the American Medical Association.

About half of all healthy adults in the United States are exposed to CMV during their life, researchers estimate, and control the infection with their immune system, often without even experiencing symptoms. In some people with reduced immune function, such as organ-transplant recipients, the virus can re-activate in the body and cause serious health problems.

In this study, researchers looked at CMV reactivation in 120 patients with no immune-system problems who were admitted to a hospital ICU. They also analyzed how CMV reactivation affected a patient's long-term health outcomes, including the amount of time the patient had to spend in the hospital or ICU and their risk of death.

The researchers found that CMV reactivation was surprisingly common in ICU patients, with about 30 percent exhibiting an active CMV infection in their bloodstream at various points during the 30-day study period. Even when controlling for other possible variables, CMV reactivation was strongly associated with a longer hospital and ICU stay for patients.

"Other studies have looked at the reactivation rate of CMV, but what makes this study different is that we're looking at people with apparently normal immune systems who were being treated in the ICU for trauma or another medical problem," explained Dr. Ajit Limaye, associate professor of medicine and laboratory medicine at the UW, who led the study. "A substantial number of these patients had CMV reactivate in their bloodstream. What's interesting is that having the virus reactivate was associated with longer ICU and hospital stays, independent of other potential variables."

Longer hospital stays can drive up health-care costs, and can be inconvenient or uncomfortable for patients, Limaye added.

Patients without immune system problems are not typically tested for CMV. However, despite the study findings, Limaye said, it would be premature to start routine testing of ICU patients for reactivation of the virus.

First, the researchers will need to see whether using anti-viral drugs to treat regular-immunity ICU patients can help cut down on reactivation of CMV, or whether it can cut down on the length of hospital stays for those patients with the reactivated virus.

"There are side effects associated with the treatment for CMV, and CMV might simply be a marker, rather than a cause," Limaye explained. "Because of that, we need to test the theory that by treating CMV we can improve the endpoint -- the length of stay in the hospital."

If the planned clinical trial shows that treatment can cut down on CMV reactivation and reduce hospital stays for those patients, Limaye said, it could bring about a new paradigm for improving outcomes for hospital ICU patients. ICUs are typically focused on pulmonary and critical care, he explained, but CMV is an infectious-disease issue.

University of Washington

---

---

	The Immune System by Peter Parham (Author) The Immune System, Third Edition emphasizes the human immune system and synthesizes immunological concepts into a comprehensible, up-to-date, and reader-friendly account of how the immune system works.  Written for undergraduate, medical, veterinary, dental, and pharmacy students in immunology courses, it makes generous use of medical examples to illustrate points.  The Third Edition has been extensively revised and updated and includes two new chapters on innate and adaptive immunity, which explore the physical, cellular, and molecular principles underlying these responses to infection.  It also features enhanced coverage of aspects of innate immunity such as the complement system, Toll-like receptors, defensins, and C-reactive protein; the role of dendritic cells in...
	In Defense of Self: How the Immune System Really Works by William R. Clark (Author) We live in a sea of seething microbial predators, an infinity of invisible and invasive microorganisms capable of setting up shop inside us and sending us to an early grave. The only thing keeping them out? The immune system. William Clark's In Defense of Self offers a refreshingly accessible tour of the immune system, putting in layman's terms essential information that has been for too long the exclusive province of trained specialists. Clark explains how the immune system works by using powerful genetic, chemical, and cellular weapons to protect us from the vast majority of disease-causing microbes-bacteria, viruses, molds, and parasites. Only those microbes our bodies need to help us digest food and process vitamins are admitted. But this same system can endanger us by...
	How the Immune System Works (Blackwell's How It Works) by Lauren M. Sompayrac (Author) Understanding the immune system is crucial for both medical and bioscience students, with new research revealing yet more secrets year on year. Many books offer in-depth introductions to the subject, but How the Immune System Works remains uniquely popular for its personable and practical overview of the nuts and bolts of the immune system. This third edition provides a perfect introduction to the essential principles of the immune system, covered in humorous but highly informative 'lectures' accompanied by clear and accessible illustrations. It is perfect for exam preparation or as an enjoyable overview of a difficult subject. Both students and instructors will welcome the clarity and authority that Lauren Sompayrac brings to this timely revision.
	How the Immune System Works, Includes FREE Desktop Edition (BLACKWELL'S HOW IT WORKS SERIES) by Lauren M. Sompayrac (Author) How the Immune System Works is not a comprehensive textbook. It’s the book thousands of students have used to help them understand what’s in their big, thick, immunology texts. In this book, Dr. Sompayrac cuts through the jargon and details to reveal, in simple language, the essence of this complex subject. Fifteen easy to follow lectures, featuring the uniquely popular humorous style and engaging analogies developed by Dr Sompayrac, provide an introduction to the ‘bigger picture’, followed by practical discussion on how each of the components interacts with one another. Now featuring full-color diagrams, this book has been rigorously updated for its fourth edition to reflect today’s immunology teaching and includes updated discussion of B and T cell memory, T cell...
	90 Day Immune System Revised: This vital life-saving information will help you: Protect your body from diseases and early aging Maximize your ... and surveys Boost your vitality and b by Janet Maccaro (Author) GIVE YOURSELF 90 DAYS TO... Build and strengthen your immune system. Bring your body's system into proper balance Experience disease-free living. No matter what your health has been in the past, there is something you can do right now to give your entire body a complete makeover! Dr. Janet explains how you can improve the quality of your life with: Imagine what your life could be like with a complete immune system makeover! You best days of health are ahead of you. What are you waiting for?
	The Immune System by Peter Parham (Author) The Immune System, Second Edition has been designed for use in immunology courses for undergraduate, medical, dental, and pharmacy students. This class-tested and successful textbook synthesizes the established facts of immunology into a comprehensible, coherent, and up-to-date account of how the immune system works, rather than presenting immunology as a chronology of experiments and discoveries. Emphasizing the human immune system the text has been designed to break down the barriers which often divide basic and clinical immunology. The reader-friendly text, section and chapter summaries, and full-color illustrations make the book accessible and easily understandable to students. The Immune System is adapted from Immunobiology by Janeway, Travers & Walport.
	Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion, Fourth Edition by Elizabeth Lipski (Author) The definitive guide to healthy digestion! Digestive Wellness explains how your digestive system works and what to do when it doesn’t. You’ll find practical solutions to all the common gastrointestinal disorders (and many other conditions) and expert guidance on the newest advances in testing and diagnosis, nutrition, and natural therapies. Plus, you’ll learn how faulty digestion can affect the human body systemically, from migraines and skin issues to fibromyalgia and chronic fatigue syndrome. “Dr. Lipski offers a practical toolkit to support each of us—clinicians and patients—to return to wellness by bringing our gastrointestinal system back into balance and harmony. I believe that you will deeply benefit from joining Dr. Lipski on this journey toward digestive...
	Basic Immunology Updated Edition: Functions and Disorders of the Immune System With STUDENT CONSULT Online Access, 3e (Basic Immunology: Functions and Disorders of the Immune System) by Abul K. Abbas MBBS (Author), Andrew H. Lichtman MD PhD (Author) This updated 3rd edition of Basic Immunology provides a readable and concise introduction to the workings of the human immune system, with emphasis on clinical relevance. The format makes learning easy with short, easy-to-read chapters, color tables, key point summaries, and review questions in every chapter. You'll get the latest coverage on regulatory T cells, biology of the Th17 subset of CD4+ T cells, and more. The full-color artwork, comprehensive glossary, and clinical cases are just some of the features that reinforce and test your understanding of how the immune system functions. Student Consult online access lets you search the full text online and pursue further study through integration links. Covers the most up-to-date immunology information including regulatory T cells, and...
	Super Immunity: The Essential Nutrition Guide for Boosting Your Body's Defenses to Live Longer, Stronger, and Disease Free by Joel Fuhrman (Author) Why do some of us get sick with greater frequency than others? What makes us more susceptible to illness? Are we doomed to get sick when our coworkers and family members do? Is there a secret to staying healthy? Joel Fuhrman, M.D., a leading expert and board-certified medical specialist in prevention and reversing disease, offers a comprehensive guide to superior health. Based on the latest scientific research, Super Immunity shows us how we can become almost totally resistant to colds, influenza, and other infections. The evidence is overwhelming: we can supercharge our immune system to protect our bodies against disease—everything from the common cold to cancer. Nutritional science has made phenomenal strides and discoveries in recent years, and when this new...
	The Immune System Cure: Optimize Your Immune System in 30 Days-The Natural Way! by Lorna Vanderheaghe (Author) What causes one person to catch a cold or flu and another to avoid it? Why do serious outbreaks of infectious diseases leave some individuals untouched? What allows someone to be incapacitated by allergies? The answer lies within nature itself-our immune system. The Immune System Cure provides simple techniques for supercharging your immune system to resist and prevent disease. Through diet, exercise, stress reduction and nutritional supplements, including plant sterols and sterolins, you can harness the power of your immune system in just 30 days and help it combat: Antibiotic-resistant bacteria Fibromyalgia Allergies Hepatitis C Tuberculosis Cancer Rheumatoid arthritis and other autoimmune diseases Chronic fatigue syndrome and more Now you can maintain a healthy...