Cytomegalovirus infection in ulcerative colitis: A prospective, comparative study on prevalence and diagnostic strategy

Domènech, Eugeni; Vega, Roser; Ojanguren, Isabel; Hernández, Á; García‐Planella, Esther; Bernal, Isabel; Rosinach, Mercé; Boix, Jaume; Cabré, Eduard; Gassull, Miquel A.

doi:10.1002/ibd.20498

Cited by 181 publications

(181 citation statements)

References 42 publications

(37 reference statements)

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“…Our data are consistent with the findings of both Roblin and Domènech that mucosal inflammation in UC, rather than immunosuppressive therapy such as with CS, contributes to the colonic CMV reactivation in intestinal tissue. 14,29 An interesting finding was that the positive rate of CMV-DNA was significantly lower in UC patients treated with AZA/6MP than in those without. In vitro data showing the proliferation of CMV in fibroblasts inhibited by AZA/6MP support our clinical observation.…”

Section: Discussionmentioning

confidence: 99%

Effect of intensive granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis positive for cytomegalovirus

Fukuchi

Nakase

Matsuura

et al. 2013

Journal of Crohn's and Colitis

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Background and aim: Cytomegalovirus (CMV) exacerbates ulcerative colitis (UC) refractory to immunosuppressive therapies. The conditions under which CMV reactivation occurs in patients with UC, however, is unclear. In addition, the diagnostic and treatment strategies for UC positive for CMV have not been established. Granulocyte and monocyte adsorptive apheresis (GMAA) is natural biological therapy for UC in which the granulocytes/macrophages producing inflammatory cytokines are removed. We investigated the rate of colonic CMV reactivation and the efficacy of GMAA in active UC patients positive for CMV without concomitant corticosteroid (CS) therapy. Methods: Fifty-one active UC patients without concomitant CS therapy were enrolled. Colonic CMV reactivation was examined by real-time polymerase chain reaction (PCR) using biopsy specimen and/or histological examination. All patients were treated with intensive GMAA (twice per week). Rates of clinical remission and mucosal healing were compared between UC patients positive and negative for CMV. Results: Of 51 patients, 15 (29.4%) were diagnosed as CMV positive. The clinical remission rates following intensive GMAA did not differ between UC patients positive and negative for CMV (73.3% vs 69.4%, p = 0.781). Proportion of patients achieving mucosal healing was also similar A v a i l a b l e o n l i n e a t w w w . s c i e n c e d i r e c t . c o m ScienceDirectJournal of Crohn's and Colitis (2013) 7, 803-811 Downloaded from https://academic.oup.com/ecco-jcc/article-abstract/7/10/803/378961 by guest on 07 June 2019 between these two groups. CMV-DNA became negative in all UC patients positive for CMV who achieved clinical remission 1 week after completion of intensive GMAA. Conclusions: Intestinal inflammation might trigger CMV reactivation in a subpopulation of active UC patients without CS treatment. GMAA could be a promising option for active UC positive for CMV.

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Section: Discussionmentioning

confidence: 99%

Effect of intensive granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis positive for cytomegalovirus

Fukuchi

Nakase

Matsuura

et al. 2013

Journal of Crohn's and Colitis

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“…However, age and disease duration were found to be insignificant variables regarding the prevalence of CMV colitis in previous reports (2,4,(6)(7)(8)(9).…”

Section: Resultsmentioning

confidence: 60%

“…It is often difficult to diagnose CMV infection in patients with UC, even when using this combined method. Several recent studies indicate that the real-time tissue PCR assay allows more sensitive and rapid detection of CMV-DNA in clinical samples, and is more useful and beneficial for diagnosis of CMV infection than CMV antigenemia assay or histologic examination (8,18 is much higher among case reports. This could be due to delay in introducing the treatment in relation to the more meticulous assessment of patients in case base or overestimation of the severity of the clinical condition.…”

Section: Resultsmentioning

confidence: 99%

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Prevalence, predictive factors and ideal treatment of cytomegalovirus infection in IBD patients

Köroğlu

Çelık²

2012

Turk J Gastroenterol

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“…CMV may produce retinitis, pneumonia, encephalitis, and other invasive infections [59] . A number of studies have described an association between severe steroidrefractory IBD and CMV infection [60,61] . Colonic CMV disease was observed in steroid-refractory UC (active), with a prevalence of 32% [60] in a prospective case-control report.…”

Section: Cytomegalovirusmentioning

confidence: 99%

What is the best way to manage screening for infections and vaccination of inflammatory bowel disease patients?

Andrisani

Armuzzi

Marzo

et al. 2016

WJGPT

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increased risk of opportunistic infections, in particular of viral or bacterial etiology. Despite the existence of international guidelines, many gastroenterologists have not adopted routine screening and vaccination in those patients with IBD, which are candidate for biologic therapy. Available strategies to screen, diagnose and prevent bacterial and viral infections in patients with IBD prior to start biological therapy are discussed in this review. Core tip: The increasing use of biologics as a mainstay of therapy in inflammatory bowel disease (IBD) is associated with an increased risk for a variety of infections, many of which are preventable by prior screening and vaccination. While immunocompetent IBD patients can be vaccinated using standard vaccination schedule, special guidelines need to be followed for IBD patients getting immunosuppressive therapy (IST). This article provides a review of the issues surrounding immunizations in the IBD patient and a practical guide for clinicians regarding the appropriate screening for infections and vaccinations to administer both before and during IST. AbstractThe use of biological agents and immunomodulators for inflammatory bowel disease (IBD) is associated with an REVIEWSubmit a

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Cytomegalovirus infection in ulcerative colitis: A prospective, comparative study on prevalence and diagnostic strategy

Abstract: CMV disease in UC only affects seropositive, steroid-refractory UC patients. Steroid/cyclosporine treatment together with disease activity may predispose to latent colonic CMV reactivation. The impact of antiviral therapy on the clinical outcome of these patients remains to be elucidated.

Cited by 181 publications

References 42 publications

Effect of intensive granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis positive for cytomegalovirus

Effect of intensive granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis positive for cytomegalovirus

Prevalence, predictive factors and ideal treatment of cytomegalovirus infection in IBD patients

What is the best way to manage screening for infections and vaccination of inflammatory bowel disease patients?

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