ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease

Kucharzik, Torsten; Ellul, Pierre; Greuter, Thomas; Rahier, Jean François; Verstockt, Bram; Abreu, Cândida; Albuquerque, Andreia; Allocca, Mariangela; Esteve, María; Farraye, Francis A.; Gordon, Hannah; Karmiris, Konstantinos; Kopylov, Uri; Kirchgesner, Julien; MacMahon, Eithne; Magro, Fernando; Maaser, Christian; Ridder, Lissy de; Taxonera, Carlos; Törüner, Murat; Tremblay, Lydjie; Scharl, Michael; Viget, N.; Zabana, Yamile; Vavricka, Stephan R.

doi:10.1093/ecco-jcc/jjab052

Cited by 196 publications

(184 citation statements)

References 504 publications

(404 reference statements)

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“…Due to the immunosuppressant effects of these medications, patients are at risk of the reactivation of chronic infections, in particular HBV and TB [6]. The European Crohn's and Colitis Organisation (ECCO) provides an updated, evidence-based consensus on screening recommendations for opportunistic infections in IBD patients receiving biologic therapy [3][4][5]. Screening for HBV and TB prior to initiating and routinely during biologic therapy has been well established in the literature [3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…The European Crohn’s and Colitis Organisation (ECCO) provides an updated, evidence-based consensus on screening recommendations for opportunistic infections in IBD patients receiving biologic therapy [ 3 - 5 ]. Screening for HBV and TB prior to initiating and routinely during biologic therapy has been well established in the literature [ 3 - 5 ]. With regards to HIV, ECCO has adjusted its screening guidelines over the past decade.…”

Section: Discussionmentioning

confidence: 99%

“…The World Health Organization defines high-risk factors as same-sex relationships in men, the use of contaminated needles, and concomitant sexually transmitted diseases [ 8 ]. In HIV-positive patients, the updated ECCO 2021 guidelines recommend achieving a stable CD4 count and an undetectable viral load on HAART prior to beginning immunosuppression [ 5 ]. These patients did not appear to be at an increased risk of opportunistic infections from immunosuppression [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The use of biologic therapy is becoming the standard of care treatment in IBD, especially in Crohn's disease [1,2]. Routine testing for chronic HBV and TB is recommended due to the risk of disease reactivation during the initiation and maintenance therapy [3][4][5]. However, the recommendation for HIV screening has evolved in the past decade [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Routine testing for chronic HBV and TB is recommended due to the risk of disease reactivation during the initiation and maintenance therapy [3][4][5]. However, the recommendation for HIV screening has evolved in the past decade [3][4][5]. This modification in screening guidelines holds particular importance in individuals at high-risk of contracting HIV, as further immunosuppression may place this population at higher risk for opportunistic infections.…”

Section: Introductionmentioning

confidence: 99%

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Biologic Therapy in HIV: To Screen or Not to Screen

Davis¹,

Vavilin²,

Malhotra³

2021

Cureus

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Biologic therapy has revolutionized the management of chronic inflammatory diseases, including inflammatory bowel disease (IBD). Before the initiation of therapy, it is critical to rule out prior infection of chronic hepatitis B virus (HBV) and tuberculosis (TB). However, screening for human immunodeficiency virus (HIV) is not as routinely completed. We present a case of a 56-year-old male on ustekinumab for the management of Crohn's disease, found to have undiagnosed human immunodeficiency virus (HIV) with progression to acquired immunodeficiency syndrome (AIDS).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Biologic Therapy in HIV: To Screen or Not to Screen

Davis¹,

Vavilin²,

Malhotra³

2021

Cureus

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Clinical validation of serum immunosignatures in early diagnosis of Crohn's disease

Ma,

Zhang,

Wang

et al. 2023

iLABMED

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BackgroundThe search for biomarkers suitable for early diagnosis of Crohn's disease (CD) is challenging. This study investigated the efficacy of serological markers for the early diagnosis of CD.MethodsThis was a retrospective nested cohort study. Indirect immunofluorescence and enzyme‐linked immunosorbent assay were used to detect ASCA IgG, ASCA IgA, AYMA IgG, AYCA IgG, FI2Y IgG, p‐ANCA IgG, GAB IgG and PAB IgG in patient serum samples.ResultsThe positive rates of ASCA IgG, ASCA IgA, AYMA IgG, AYCA IgG, FI2Y IgG, p‐ANCA IgG, GAB IgG and PAB IgG in patients with early CD, advanced CD and other intestinal diseases were 37.0% versus 56.8% versus 27.8%; 3.7% versus 20.5% versus 19.4%; 14.8% versus 2.3% versus 2.8%; 25.9% versus 9.1% versus 8.3%; 18.5% versus 15.9% versus 8.3%; 0.0% versus 2.8%, 18.5%; 13.6% versus 18.2% versus 16.7%; and 7.4% versus 20.5% versus 0.0%, respectively. The positive rates of ASCA IgG, AYCA IgG and PAB IgG were significantly different among the three groups (p < 0.05). In 85.2% of early CD patients, at least one antibody was detected 1 year before diagnosis. The sensitivity of the ASCA/AYMA/AYCA/FI2Y/GAB combination for early diagnosis was 85.2%. The sensitivity of the ASCA/AYMA/AYCA/FI2Y/GAB/PAB/PANCA combination for differentiating CD from other diseases was 87.3%.ConclusionsASCA IgG and AYCA IgG have potential value in identifying the course of CD. AYCA IgG may be a potential marker for the early diagnosis of CD, and ASCA IgG indicates an advanced stage. The combination of ASCA, AYMA, AYCA, FI2Y, and GAB improves early diagnostic accuracy of CD.

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Periodontitis prevalence and severity in inflammatory bowel disease: A case–control study

Baima

Muwalla

Testa

et al. 2022

Journal of Periodontology

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Background: Recent evidence is supporting the notion of a microbiological and immunological continuum on the gum-gut axis in health and disease. Therefore, the purpose of this study was to assess the prevalence and risk indicators of periodontitis in patients with Crohn's disease (CD) or ulcerative colitis (UC) compared to age-and sex-matched controls without inflammatory bowel disease (IBD). Methods: A total of 180 IBD (117 CD, 60 UC, 3 IBD-unclassified) and 180 healthy controls were compared for their periodontitis diagnosis (Centers for Disease Control and Prevention/American Academy of Periodontology [CDC/AAP] case definition) and full-mouth periodontal parameters. In addition, explorative logistic regression models were performed. Results: Significantly more patients with IBD had moderate/severe periodontitis (85.6% vs. 65.6%, p < 0.001) and severe periodontitis (36.7% vs. 25.6%, p < 0.001) than controls. Differences were higher in the 35-50 and 51-65 age groups, without significant changes between CD and UC. IBD subjects presented chances ∼3.5 higher of having moderate/severe periodontitis (p < 0.001). Significant variables associated with periodontitis in the whole sample were older age, presence of IBD, and higher full-mouth plaque scores, whereas in the IBD group they were male sex, IBD-associated surgery, and IBD duration and localization (pancolitis).Positive risk indicators for IBD were periodontitis severity and higher bleeding scores, while smoking was negatively associated with UC.Conclusions: Relevant associations between IBD and periodontitis were found, being modified by CD and UC clinical characteristics. Preventive and therapeutic strategies involving the gum-gut axis should be enforced in IBD patients.

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ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease

Cited by 196 publications

References 504 publications

Biologic Therapy in HIV: To Screen or Not to Screen

Biologic Therapy in HIV: To Screen or Not to Screen

Clinical validation of serum immunosignatures in early diagnosis of Crohn's disease

Periodontitis prevalence and severity in inflammatory bowel disease: A case–control study

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