Source: Annual Congress 2006 - Virus-induced respiratory tract infection
Disease area: Interstitial lung diseases

Abstract

Introduction
Interstitial lung abnormalities may be due to a wide range of disorders. Medical work-up including a bronchoalveolar lavage (BAL) not always results in a diagnosis. To elucidate a possible role of herpes virus in the pathogenesis of interstitial lung abnormalities, Epstein-Barr (EBV) and Cytomegalovirus (CMV) viral loads were determined in BAL fluid and serum.
Methods
In this prospective study, 33 patients with new interstitial lung abnormalities, who underwent a BAL were included. In most cases matching serum was obtained. BAL fluids and sera were analysed for the presence of EBV- and CMV-DNA using real-time EBV- and CMV-PCR. EBV and CMV serology was carried out on available specimens.
Results
Seventeen (52%) out of 33 BAL specimens contained EBV DNA (median 3043, range 183-4,000,000 geq/mL). From 25 of 33 patients serum was available. In 6 (46%) out of 13 patients with an EBV positive BAL fluid, EBV DNA was present in serum (median 427, range 70-2,098 geq/mL). EBV DNA was not detectable in the sera (0/12) of patients with an EBV negative BAL fluid (p=0.015).
CMV DNA was detectable in 5 out of 31 (16%) BAL specimens (median 1,725, range 163-2,800,435 geq/mL). In 3 out of these 5 (60%) serum CMV PCR was positive (median 677, range 296-4,474 geq/mL). CMV DNA was not detected in serum (0/19) of patients with a CMV negative BAL result (p=0.005).
Conclusions
1. EBV is detectable in BAL fluid in a remarkable number of cases presenting with interstitial lung disease, whereas CMV seems to play a much less prominent role.
2. Systemic reactivation, reflected by positive PCR results in serum, of both EBV or CMV infection was only seen in patients with EBV- or CMV-PCR positive BAL fluids.

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M. P. D. Deege, S. F. T. Thijsen, R. Luderer, J. W. A. Rossen, A. M. V. Loon, J. M. H. V. Gorp, A. W. J. Bossink (Utrecht, Netherlands). EBV and CMV as possible pathogens in patients presenting with interstitial lung disease. Eur Respir J 2006; 28: Suppl. 50, 967

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