Assessment of Active Cytomegalovirus (CMV) and Epstein-Barr Virus (EBV) Infections and Patient Reported Fatigue in Ovarian Cancer Survivors

Fatigue is a common symptom reported by individuals treated for ovarian cancer. The objective of this study was to determine whether fatigue following chemotherapy for ovarian cancer is related to biomarkers of active cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection.

We conducted a cross-sectional study among individuals diagnosed with ovarian, primary peritoneal, or fallopian tube cancer in Minnesota who had completed frontline chemotherapy, irrespective of current treatment status. Participants completed a survey and provided a blood sample. The primary exposures of interest were active CMV or EBV infections, determined by measuring CMV and EBV DNA levels in plasma (DNAemia). We also assessed serology-based markers of CMV infection and quantified levels of high-sensitivity C-reactive protein (hsCRP), as a biomarker of systemic inflammation. Symptoms of fatigue were self-reported using the Fatigue Symptom Inventory. We examined associations between fatigue symptoms and CMV and EBV by infection status, with and without inflammation, using two-sided t-tests and multivariable linear regression models accounting for confounding factors.

Among the 160 eligible participants, 64 (40.0%) demonstrated CMV DNAemia+, 56 (35.0%) had EBV DNAemia+, and 32 (20.0%) were positive for both. There were no significant associations between CMV or EBV DNAemia and fatigue. Similarly, CMV IgG and hsCRP status, alone or combined with CMV status, were not associated with fatigue scores.

We did not observe associations between CMV DNAemia, EBV DNAemia, or hsCRP and fatigue in this survivor population. Further investigation is needed to identify causes and indicators of cancer-related fatigue following treatment for ovarian cancer.