Associations of cytomegalovirus infection with cancer-related cognitive impairment and peripheral neuropathy in ovarian cancer survivors
To assess the associations between active CMV infection and patient-reported symptoms of cancer-related cognitive impairment (CRCI) and peripheral neuropathy in ovarian cancer survivors. We conducted a cross-sectional study among individuals with a diagnosis of ovarian cancer, primary peritoneal cancer, or fallopian tube cancer from academic and community cancer clinics at any time point after completion of front-line chemotherapy. Participants completed a one-time survey and provided a blood sample. Plasma virus DNA levels were measured using digital PCR, with ≥100 copies/mL of plasma considered active infection (CMV+, EBV+ as a control). We measured symptoms of CRCI and peripheral neuropathy using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function short form 8a and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group - Neurotoxicity (FACT/GOG-NTX) subscale measurements, respectively. Symptoms were compared by active CMV infection status in the full group and among the subgroup receiving active treatment using t-tests and linear regression models. 152 participants were included. A total of 59 (38.8 %) participants were CMV+. After adjustment for potential confounding variables, individuals who were CMV+ self-reported significantly more symptoms of peripheral neuropathy that those who were CMV- (p = 0.04). In the subgroup of participants currently receiving chemotherapy, individuals who were CMV+ had significantly lower perceived cognitive functioning compared to individuals who were CMV- (p = 0.03); this was not observed in the full cohort. No associations were observed between outcomes and EBV infection. Active CMV infection is common in this survivor population and may be associated with more symptoms of CRCI and neuropathy.