Abstract：
Although Epstein-Barr virus (EBV) reactivation has long been associated with the pathogenesis of systemic lupus erythematosus (SLE), many aspects of this relationship remain unclear. Our objective was to investigate the association between EBV reactivation and the achievement of SLE remission and lupus low disease activity state (LLDAS) over a six-month period. Clinical, laboratory, and virological tests (anti-EBV antibodies and EBV DNA) were performed among 51 patients with the active form of SLE on two occasions six months apart. SLE remission and LLDAS achievement were assessed at the end of the follow-up period. Active EBV infection was detected in 45% of active SLE patients at baseline, and 77% transitioned to latent EBV infection at six months (p < 0.001). Multivariate regression revealed a higher titer of anti-EA(D) IgM-Abs and the presence of anti-EA(D) IgM-Abs as independent predictors of remission and LLDAS in SLE patients with mucocutaneous manifestations (p = 0.042) and rash only (p = 0.023), respectively. Since a higher C3 level was an independent predictor of transition to latent EBV infection (p = 0.027), the estimated cut-off value that could identify active SLE patients who will transition to latent EBV infection after six months was ≥0.780 g/L with a sensitivity of 70.6% and a specificity of 75.0% (AUC = 0.756, p = 0.003). EBV reactivation is common in patients with active SLE, and most of them transition to latent EBV infection after six months. Achieving remission and LLDAS in SLE patients with mucocutaneous manifestations can be predicted by a higher titer, whereas in SLE patients who have only a rash, the presence of anti-EA (D) IgM-Abs was a predictor of remission and LLDAS.
摘要：
尽管爱泼斯坦-巴尔病毒（EBV）的再激活长期以来与系统性红斑狼疮（SLE）的发病机制有关，这种关系的许多方面仍不清楚。我们的目的是在六个月的时间内研究EBV再激活与SLE缓解和狼疮低疾病活动状态（LLDAS）之间的关系。临床,实验室,和病毒学测试(抗EBV抗体和EBVDNA)对51例活动性SLE患者进行了两次,间隔6个月.在随访期结束时评估SLE缓解和LLDAS成就。在基线时，在45％的活动性SLE患者中检测到活动性EBV感染，77%在6个月时转变为潜伏性EBV感染(p<0.001)。多因素回归分析显示，在皮肤黏膜表现（p=0.042）和皮疹（p=0.023）的SLE患者中，抗EA（D）IgM-Abs的滴度较高，抗EA（D）IgM-Abs的存在是缓解和LLDAS的独立预测因子。分别。由于较高的C3水平是过渡到潜伏EBV感染的独立预测因子（p=0.027），能够识别6个月后转化为潜伏EBV感染的活动性SLE患者的估计临界值为≥0.780g/L,敏感性为70.6%,特异性为75.0%(AUC=0.756,p=0.003).EBV再激活常见于活动性SLE患者，他们中的大多数在六个月后过渡到潜伏的EBV感染。获得缓解和LLDAS在SLE患者的粘膜皮肤表现可以通过更高的滴度预测，而在只有皮疹的SLE患者中，抗EA(D)IgM-Abs的存在是缓解和LLDAS的预测因子.
