Original Articles
Vol. 18 No. 1 (2026): Mediterranean Journal of Hematology and Infectious Diseases
https://doi.org/10.4084/MJHID.2026.050

The ASSOCIATED FACTORS ON CYTOMEGALOVIRUS REACTIVATION OF CRITICALLY ILL IMMUNOCOMPETENT PATIENTS

Cytomegalovirus Reactivation of Critically Ill Patients.

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Published: June 30, 2026
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Cytomegalovirus, Critical Care, Antiviral Therapy, hemoglobin, intensive care unit

Authors

Sumeyye Kazancioglu
sumeyye_yildiz@hotmail.com
a:1:{s:5:"en_US";s:28:"Ankara Bilkent City Hospital";}, Türkiye.
Ebru Ayöztürk
Seval Izdes
Rahmet Guner

Background: Critically ill patients in intensive care units (ICUs) are susceptible to cytomegalovirus (CMV) reactivation. Increased mortality, length of ICU stay, and duration of mechanical ventilation (MV) were associated with CMV in these patients.

Methods: The patients who received antiviral therapy (ganciclovir) for CMV reactivation (n=39) were compared with patients without viremia (n=39).

Results: The reactivation group had higher mortality rates (n=28, 71.8%) than the control group (n=15, 28.5%). Logistic regression analysis showed that length of ICU stay, the day of steroid treatment, duration of MV, alanine aminotransferase (ALT), and hemoglobin level were identified as independent predictors of CMV reactivation. The optimal cut-off value of ALT was found to be >58 IU/ml (p<0.001, AUC: 0.721, sensitivity: 56.41, specificity: 87.18), and hemoglobin was found to be ≤ 9.8 g/dL (p<0.001, AUC: 0.708, sensitivity: 56.41, specificity: 84.62). In patients who received antiviral therapy, the baseline DNA levels were higher in the non-survivor group (n=28), but no statistically significant difference was detected. A downward trend of viremia level was seen in both non-survivors and survivors (n=11) groups.

Conclusions: Reactivation had an impact on mortality; despite antiviral therapy and polymerase chain reaction (PCR) monitoring, it was also associated with increased length of ICU stay, MV, and steroid treatment. Lower hemoglobin and increased ALT levels can be considered as guiding laboratory parameters in predicting CMV reactivation.

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How to Cite



“The ASSOCIATED FACTORS ON CYTOMEGALOVIRUS REACTIVATION OF CRITICALLY ILL IMMUNOCOMPETENT PATIENTS: Cytomegalovirus Reactivation of Critically Ill Patients”. (2026) Mediterranean Journal of Hematology and Infectious Diseases, 18(1), p. e2026050. doi:10.4084/MJHID.2026.050.
Copyright (c) 2026 Sumeyye Kazancioglu, Ebru Ayöztürk, Seval Izdes, Rahmet Guner Creative Commons License

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