Underlying Viral Etiology in Behcet's Disease: A Systematic Review

Abstract

Introduction

Bechet's disease is a rare auto-inflammatory systemic vasculitis characterized by recurrent oral and genital ulcerations, chronic uveitis, and vasculitis affecting arteries and veins of all sizes. Left untreated, it can lead to more severe complications such as stroke and blindness. Behcet's disease primarily affects individuals who are in their 20s to 40s, however the cause of the condition is still unknown. Additionally, there is a higher prevalence in Middle Eastern, Asian, and Mediterranean patients, suggesting a possible association with genetic predisposition and environmental influences. Other studies have indicated viral infection may play a role in the pathogenesis of Behcet's disease.

Methods

Articles in English were identified from January 1960 through March 2024 using PubMed and SCOPUS, adhering to the updated 2020 standards of the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement. Search terms were ‘Bechet's disease’ and ‘case report’. Relevant abstracts were retrieved and assessed for inclusion by three reviewers.

Results

Out of 1127 studies identified, 467 met inclusion criteria. 73% of the studies (343) did not report/assess the viral status of the patient. Of the 124 studies that did report viral status, 9.7 % of patients (12) were found to be positive for one or more viruses. The most common virus identified was cytomegalovirus (CMV), which was positive in 3 patients.

Conclusion

Behcet's disease, though rare, remains poorly understood. Advancements in understanding its etiology and risk factors could lead to improved treatments and patient oues.