medwireNews: Results from a retrospective analysis suggest that cytomegalovirus (CMV) seropositivity at anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis diagnosis is an independent risk factor for developing venous thromboembolism (VTE).
During a median follow-up of 8.5 years, 12% of the 259 individuals who attended vasculitis clinics at University Hospitals Birmingham NHS Foundation Trust, UK, in 2014–2015 developed VTE, corresponding to an incidence of 1.4 cases per 100 person–years.
Catherine King (University of Birmingham, UK) and colleagues note that “the highest risk for a VTE was around the time of disease activity,” and report 12 events occurring during the first 90 days after diagnosis of ANCA-associated vasculitis, and an incidence of 6.9 cases per 100 person-years during active disease within the first 12 months. This contributes to “the morbidity and mortality associated with the disease,” they add.
Sixty-one percent of the study cohort tested positive for CMV immunoglobulin (Ig)G at ANCA-associated vasculitis diagnosis. Among these, 16% had a VTE event compared with 5% of those who were CMV seronegative, suggesting an increased risk for VTE among seropositive individuals.
Increased levels of inflammation at diagnosis were also associated with VTE rates, with a median C-reactive protein (CRP) of 139 mg/L in those with versus 44 mg/L in those without VTE.
In a multivariable analysis, CMV seropositivity and CRP levels at diagnosis were independent predictors of VTE, with hazard ratios of 2.96 and 1.01, respectively.
To validate these results, data from the UK cohort was compared with that for 68 individuals presenting at a US center with a new diagnosis of ANCA-associated vasculitis in 2014–2019 who were followed up for a median of 1.6 years. In this group, 9% of people experienced a VTE event, which resulted in an incidence of 4.7 per 100 person–years.
In this cohort, 15% of CMV IgG-seropositive individuals had a VTE while no events were reported in CMV-seronegative individuals.
“The data from the validation cohort confirmed that CMV seropositivity at diagnosis was a significant risk factor for VTE,” write King et al in Arthritis Research & Therapy.
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