Associations of cytomegalovirus infection with cancer-related cognitive impairment and peripheral neuropathy in ovarian cancer survivors

Objective: To assess the associations between active CMV infection and patient-reported symptoms of cancer-related cognitive impairment (CRCI) and peripheral neuropathy in ovarian cancer survivors. Methods: We conducted a cross-sectional study among individuals with a diagnosis of ovarian cancer, primary peritoneal cancer, or fallopian tube cancer from academic and community cancer clinics at any time point after completion of front-line chemotherapy. Participants completed a one-time survey and provided a blood sample. Plasma virus DNA levels were measured using digital PCR, with ≥100 copies/mL of plasma considered active infection (CMV+, EBV+ as a control). We measured symptoms of CRCI and peripheral neuropathy using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function short form 8a and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group – Neurotoxicity (FACT/GOG-NTX) subscale measurements, respectively. Symptoms were compared by active CMV infection status in the full group and among the subgroup receiving active treatment using t-tests and linear regression models. Results: 152 participants were included. A total of 59 (38.8 %) participants were CMV+. After adjustment for potential confounding variables, individuals who were CMV+ self-reported significantly more symptoms of peripheral neuropathy that those who were CMV- (p = 0.04). In the subgroup of participants currently receiving chemotherapy, individuals who were CMV+ had significantly lower perceived cognitive functioning compared to individuals who were CMV- (p = 0.03); this was not observed in the full cohort. No associations were observed between outcomes and EBV infection. Conclusions: Active CMV infection is common in this survivor population and may be associated with more symptoms of CRCI and neuropathy.