Background: In addition to the conventional opportunistic infections in solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) recipients, cytomegalovirus (CMV) infection is associated with various chronic inflammatory diseases or poor outcomes in non-immunocompromised critically ill patients. To evaluate the burden or outcome of CMV replication in non-transplant individuals, we compared the incidence rates (IRs) for CMV disease and all-cause mortality between SOT recipients, HSCT recipients, and non-transplant population./nMethods: The SOT (N=16,368) and HSCT (N=10,206) cohorts between 2010 and 2015 were established using the WHO ICD-10 from the whole population-based large database of the Health Insurance Review & Assessment Service (HIRA). CMV cases, defined as symptomatic disease with isolation of virus, DNA, pp65 antigen, and pathology except CMV syndrome, were extracted with the unique codes for relief of medical costs of HIRA in the same dataset. Cox's proportional hazard regression analyses and log-rank test in the Kaplan-Meier curves were performed to compare all-cause mortality between the three groups./nResults: The CMV IRs adjusted by age and sex were significantly higher in the SOT (adjusted IR [95% confidence intervals], 33.1 [28.8-38.0] per 1,000 person-years) and HSCT recipients (5.1 [4.6-6.1] per 1,000 person-years) than in the whole population (0.58 [0.49-0.67] per 100,000 person-years). However, SOT recipients with CMV (18/283, 6.4%) had significantly lower all-cause mortality than non-transplant individuals with CMV (207/1,258, 16.5%) (adjusted hazard ratio [95% CI], 0.42 [0.25-0.67], log-rank P < 0.001)./nConclusion: These data suggest that CMV disease in patients without transplants is associated with poor outcomes.

中文翻译：

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巨细胞病毒病对移植受者和普通人群死亡率的发病率和影响：真实世界的全国队列数据

背景：除了实体器官移植 (SOT) 和造血干细胞移植 (HSCT) 受者的常规机会性感染外，巨细胞病毒 (CMV) 感染与各种慢性炎症性疾病或非免疫功能低下的危重患者预后不良有关。为了评估非移植个体中 CMV 复制的负担或结果，我们比较了 SOT 受者、HSCT 受者和非移植人群之间 CMV 疾病的发病率 (IR) 和全因死亡率。/n方法: 2010 年至 2015 年间的 SOT (N=16,368) 和 HSCT (N=10,206) 队列是使用来自健康保险审查和评估服务 (HIRA) 的基于整个人群的大型数据库的 WHO ICD-10 建立的。CMV 病例被定义为具有病毒、DNA、pp65 抗原和除 CMV 综合征外的病理分离的症状性疾病，在同一数据集中使用 HIRA 医疗费用减免的唯一代码提取。在 Kaplan-Meier 曲线中进行 Cox 比例风险回归分析和对数秩检验，以比较三组之间的全因死亡率。/n结果：在 SOT（调整后的 IR [95% 置信区间]，33.1 [28.8-38.0] 每 1000 人年）和 HSCT 受者（5.1 [4.6-6.1] 每 1000 人）中，按年龄和性别调整的 CMV IR 显着更高-年）高于整个人口（0.58 [0.49-0.67] 每 100,000 人年）。然而，携带 CMV 的 SOT 受者 (18/283, 6.4%) 的全因死亡率显着低于携带 CMV 的非移植个体 (207/1,258, 16.5%)（调整后的风险比 [95% CI], 0.42 [0.25- 0.67]，对数秩P < 0.001)./n结论：这些数据表明，未进行移植的患者的 CMV 疾病与不良预后相关。