Cytomegalovirus infection in malignant pleural mesothelioma

De Von Hunter-Schlichting, Karl T. Kelsey, Ryan Demmer, Manish Patel, Raphael Bueno, Brock Christensen, Naomi Fujioka, Deepa Kolarseri, Heather H. Nelson

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5 Scopus citations


Human cytomegalovirus (HCMV) is a highly prevalent herpes virus which persists as a latent infection and has been detected in several different tumor types. HCMV disease is rare but may occur in high-risk settings, often manifesting as a pulmonary infection. To date HCMV has not been investigated in malignant pleural mesothelioma (MPM). In a consecutive case series of 144 MPM patients we evaluated two biomarkers of HCMV: IgG serostatus (defined as positive and negative) and DNAemia (>100 copies/mL of cell free HCMV DNA in serum). Approximately half of the MPM patient population was HCMV IgG seropositive (51%). HCMV DNAemia was highly prevalent (79%) in MPM and independent of IgG serostatus. DNAemia levels consistent with high level current infection (>1000 copies/mL serum) were present in 41% of patients. Neither IgG serostatus nor DNAemia were associated with patient survival. In tissues, we observed that HCMV DNA was present in 48% of tumors (n = 40) and only 29% of normal pleural tissue obtained from individuals without malignancy (n = 21). Our results suggest nearly half of MPM patients have a high level current HCMV infection at the time of treatment and that pleural tissue may be a reservoir for latent HCMV infection. These findings warrant further investigation to determine the full spectrum of pulmonary infections in MPM patients, and whether treatment for high level current HCMV infection may improve patient outcomes.

Original languageEnglish (US)
Article numbere0254136
JournalPloS one
Issue number8 August
StatePublished - Aug 2021

Bibliographical note

Funding Information:
This work was supported by the National Institute of Health through grants awarded to NF (R35 CA197292 and P30 CA77598) and KK (R01 CA126939). The Masonic Cancer Center also supported the study through a grant given to HN (R35 00052643). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2021 Hunter-Schlichting et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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