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Higher stool and plasma CMV viral loads increased mortality risk, while longer antiviral treatment duration showed independent 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was the main objective of the study?","Question",{"text":63,"@type":64},"To evaluate prognostic factors and viral kinetics in adults with positive stool CMV polymerase chain reaction (PCR) results.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How were predictors of 30-day mortality determined?",{"text":68,"@type":64},"Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to choose viral-load cutoffs, followed by Kaplan–Meier survival analysis and Cox proportional hazards modeling.",{"name":70,"@type":61,"acceptedAnswer":71},"Which findings were associated with higher 30-day mortality?",{"text":72,"@type":64},"Higher stool and plasma CMV viral loads were independent predictors of 30-day mortality, and septic shock and steroid use were also associated with increased risk.",{"name":74,"@type":61,"acceptedAnswer":75},"What factors were associated with improved survival?",{"text":76,"@type":64},"Antiviral therapy for at least 7 days was 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inpatients with stool cytomegalovirus positivity  \nYi-Tien Hsuana,b, Ching-Hao Hsua,b,c, Cheng-Yu Chend,e, Yu-Jiun Chana,f,g, Hsin-Pai Chena,c,*  \naDivision of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bDivision of Holistic and Multidisciplinary Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; cSchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; dDepartment of Chest and Critical Care Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei, Taiwan, ROC; eNational Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC; fCenter for Infection Control, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; gInstitute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC  \nAbstract  \nBackground: The clinical association between cytomegalovirus (CMV) DNA detection in stool samples and patient outcomes remains underexplored. This study aimed to assess prognostic factors and viral kinetics in patients with positive stool CMV polymerase chain reaction (PCR) .  \nMethods: This retrospective cohort study included adult patients with positive stool CMV-PCR results at Taipei Veterans General Hospital (2016-2021) . Clinical data, plasma, and stool viral loads (VLs) were analyzed. Receiver operating characteristic (ROC) curves and area under the curve (AUC) evaluated 30-day mortality prediction, with optimal cutoffs maximizing sensitivity and specificity. Kaplan–Meier survival analyses and Cox proportional hazards models identified predictors of 30-day mortality.  \nResults: A total of 114 patients (mean age: 64.0 years, 64% male) were included. The median stool CMV VL was 629 copies/mL (interquartile range [IQR]: 263-7949) . Plasma CMV DNA was detected in 76% with a median VL of 341 copies/mL (IQR: 10-1771) . Stool and plasma VLs showed moderate correlation (ρ = 0.38, p \u003C 0.0001) . ROC analysis identified cutoffs for predicting 30-day mortality: stool 9654 copies/mL (AUC = 0.54; sensitivity 42%; specificity 81%) and plasma 1738 copies/mL (AUC = 0.60; sensitivity 47%; specificity 70%) . In multivariate Cox analysis, stool CMV VL >9,654 copies/mL (adjusted hazard ratio: [HR] 2.69, 95% confidence interval [CI]: 1.06-6.84; p = 0.04) and plasma CMV VL >1738 copies/mL (adjusted HR: 2.66, 95% CI: 1.14-6. 17; p = 0.02) were independent predictors of 30-day mortality. Septic shock and steroid use were also associated with increased mortality, whereas antiviral therapy ≥7 days was independently protective (adjusted HR: 0.26, 95% CI: 0.10-0.64; p = 0.003) .  \nConclusion: Stool and plasma CMV VLs, antiviral treatment duration, and host factors such as immune status may influence outcomes in patients with intestinal CMV reactivation. Larger studies are needed to validate optimal VL thresholds for risk stratification. Keywords: Anti-herpesvirus drug; Human cytomegalovirus; Polymerase chain reaction; Stool  \n836 [www.ejcma.org](www.ejcma.org)  \nOriginal Article. (2025) 88:11 J Chin MedAssoc  \nLay Summary: Cytomegalovirus (CMV) is a virus that can reactivate in people with weakened immune systems, particularly in the digestive tract. This study analyzed 114 patients with CMV detected in stool samples at Taipei Veterans General Hospital between 2016 and 2021. The researchers found that higher CMV levels in stool and plasma were associated with an increased risk of death within 30 days. Additional risk factors included septic shock and steroid use. In contrast, patients who received antiviral treatment for at least 7 days had improved survival. The study also demonstrated that CMV levels in blood and stool were moderately correlated, suggesting that intestinal CMV infection can affect the body more broadly. These findings emphasize the importance of monitoring stool CMV and co","cbCaikP3JIXz7B1b","https://ap.wps.com/l/cbCaikP3JIXz7B1b","pdf",2446327,"English","# Abstract\n# Introduction\n# Methods\n## Data source and patient selection\n## Virological and clinical assessments\n# Results\n# Conclusion\n# Lay Summary\n# Keywords","[{\"question\":\"What was the main objective of the study?\",\"answer\":\"To evaluate prognostic factors and viral kinetics in adults with positive stool CMV polymerase chain reaction (PCR) results.\"},{\"question\":\"How were predictors of 30-day mortality determined?\",\"answer\":\"Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to choose viral-load cutoffs, followed by Kaplan–Meier survival analysis and Cox proportional hazards modeling.\"},{\"question\":\"Which findings were associated with higher 30-day mortality?\",\"answer\":\"Higher stool and plasma CMV viral loads were independent predictors of 30-day mortality, and septic shock and steroid use were also associated with increased risk.\"},{\"question\":\"What factors were associated with improved survival?\",\"answer\":\"Antiviral therapy for at least 7 days was independently protective, showing a lower adjusted hazard of 30-day mortality.\"}]","Clinical characteristics and prognostic factors in patients with stool cytomegalovirus positivity - Study report | PDF",1790665342]