Dormant Virus Linked to Sepsis Risk

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Cytomegalovirus, or CMV, is a herpes virus found in more than half of the U.S. population over age 40. Like other herpes viruses, CMV can remain dormant inside cells for years, causing little or no apparent illness in healthy people. But in those with weakened immune systems, such as organ transplant recipients, people receiving chemotherapy, or people with AIDS, reawakening of the virus can cause serious complications or even death.

New research points to another vulnerable group: critically ill surgical patients. To see what effect CMV reactivation may have on these patients, surgeon Charles Cook, M.D., of Ohio State University in Columbus induced bacterial sepsis in mice with dormant CMV infections and in healthy, uninfected mice and then waited 2 weeks. Sepsis is a body-wide response to infection that may result in organ failure and death.

Cook observed that the dormant virus not only reawakened in the mice infected with CMV, they experienced massive lung inflammation and life-threatening breathing problems. Though these symptoms are common with prolonged sepsis, the study showed that mice with CMV reactivation experienced higher levels of inflammation than did mice with sepsis alone.

In a follow-up experiment, Cook treated the CMV-infected mice with ganciclovir, a drug known to be effective against the virus. When he gave the drug to the mice just as sepsis took hold, it blocked CMV reactivation and the serious lung injury associated with it.