Human Cytomegalovirus and Isocitrate Dehydrogenase Status in Glioma: Association and Prognosis Value in Moroccan Population

Introduction: Human cytomegalovirus (HCMV) and isocitrate dehydrogenase (IDH) have been separately associated to gliomas. IDH is a molecular marker considered in the histo-molecular classification of gliomas as well as in their management and prognosis. However, even if oncomodulatory properties were attributed to HCMV, its association to gliomas remains a controversy. Most of the studies that investigated this association used the histological classification of gliomas; nevertheless, in 2016, the World Health Organization recommended the introduction of molecular characteristics to refine this classification. The aims of this study were to determine the prevalence of HCMV in glioma patients, the association between HCMV and IDH with gliomas and subsequently their associations with survival of patients in a Moroccan cohort. Methods: A series of 102 gliomas and 32 controls were analyzed by nested PCR (nPCR) to determine the HCMV status. PCR and sequencing were used to determine the IDH subtypes in tumors samples. IDH mutation and HCMV status were correlated to the characteristics of the tumors using SPSS, whereas the survival curves were obtained by the Kaplan-Meier method and the log rank test. Results: HCMV shows significant association with gliomas with a detection rate of 30.4% and no case in the control group. The IDH mutation was identified in 40.9–50% of grade II–III gliomas and in 10.9% of grade IV gliomas. A significant association was obtained between survival in patients with glioblastomas and IDH/HCMV status. Glioblastoma patients with HCMV+ and IDHwt had a poor prognostic. Conclusions: HCMV was detected exclusively in tumor cases and was significantly associated with poor prognosis in patients with gliomas and particularly with glioblastomas. The worst overall survival was significantly seen in patients with gliomas HCMV+/IDHwt. So, it will be of interest to consider HCMV and IDH status in gliomas management strategies.