Osteonecrosis of the femoral head is associated with cytomegalovirus reactivation
Authors' conclusion
This study provides the first clinical evidence linking HCMV reactivation to ONFH
Study context
- Population
- Patients with osteonecrosis of the femoral head (ONFH) (corticosteroid-related, alcohol-related and idiopathic) and fracture controls; blood and femoral head samples
- Comparison
- ONFH patients vs fracture controls
- Outcome
- HCMV presence, distribution and reactivation in femoral head
Methodological detailsHuman cytomegalovirus (HCMV) exposure assessed by serology and viral DNA quantification; reactivation confirmed by gB immunohistochemistry and IE-1 mRNA RT-qPCR; necrotic, transitional and healthy zones analysed
- HCMV exposure assessed by serology and viral DNA quantification; reactivation confirmed by gB immunohistochemistry and IE-1 mRNA RT-qPCR; necrotic, transitional and healthy zones analysed
Main finding
As reported in the abstract
- Significantly higher HCMV DNA levels in necrotic and transitional zones of ONFH, strongly correlated with lesion volume
- gB localised predominantly in microvascular structures (small vessels, capillaries)
- IE-1 transcripts further confirmed reactivation
- HCMV reactivation observed across all ONFH etiologies: corticosteroid-related, alcohol-related and idiopathic
Original publication
Osteonecrosis of the femoral head is associated with cytomegalovirus reactivation. J Bone Miner Res. Published 6 January 2026. doi:10.
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