Reduced progression of bone erosion in cytomegalovirus seropositive rheumatoid arthritis patients
Résumé
Background:Human cytomegalovirus (HCMV) seropositivity has been associated with higher inflammation duringrheumatoid arthritis (RA). However, no data are available on the impact of HCMV seropositivity on bone erosionprogression during RA.Methods:We selected 487 individuals of ESPOIR cohort who fulfilled the 2010 ACR/EULAR criteria for RA. HCMVserology for these patients was determined using Architect CMV IgG assay. Baseline and 1-year central X-rayreading using modified Total Sharp Score (mTSS), Erosion Sharp Score, and joint space narrowing Sharp score wereused to quantify structural damage progression. We performed univariate and multivariate analyses to investigatethe association between HCMV status and bone erosion progression.Results:We analyzed 273 HCMV seropositive (HCMV+) and 214 HCMV seronegative (HCMV−) RA patients. Atinclusion, HCMV+ patients were less frequently ACPA+ (49.8% versus 58.9%,p< 0.0465) and had a higher DAS28-ESR (5.55 ± 1.24 versus 5.20 ± 1.14,p< 0.0013) in comparison with HCMV−. At 1 year, bone erosion progression(delta erosion Sharp score > 1 point) was lower in HCMV+ patients (16.1% versus 25.2%,p= 0.0128) in comparisonwith HCMV−. HCMV+ status remained independently associated with lower bone erosion progression inmultivariate analysis.Conclusions:Our findings suggest that, independently of other confounding factors, HCMV seropositivity isassociated with a lower progression of bone erosion during RA.