Prevalence of cytomegalovirus infection in patients with ulcerative colitis: a prospective cross-sectional study in Tehran, Iran
AbstractBackground and Objectives: Cytomegalovirus (CMV) infection has been reported in ulcerative colitis (UC), but limited data are available on its prevalence in Iran. The aim of this study was to evaluate the prevalence of CMV infection in patients with UC. Materials and Methods: A prospective, cross-sectional study was conducted in 86 consecutive patients with UC. Prevalence of CMV infection was determined by rectal biopsies for hematoxylin and eosin staining and PCR. CMV-positive specimens was measured for CMV loads by real-time PCR assay. Results: In six out of 86 (7%) patients with UC, CMV was diagnosed. These patients had detectable CMV DNA in their biopsies as indicated by PCR. In all CMV-positive patients, viral load was more than 250 copy/mg. Histochemical staining did not show any CMV inclusion bodies. No significant demographic and clinical differences existed between patients with and without a CMV infection. Conclusion: UC and its treatment may put patients at risk of CMV infection. Real-time PCR test for the detection of CMV in UC patients may enable diagnosis of CMV infection with a high sensitivity and allow effective treatment to be administered in these patients. The impact of antiviral therapy on the clinical outcome of the UC patients with CMV remains to be elucidated.
do Carmo AM, Santos FM, Ortiz-Agostinho CL, Nishitokukado Id, Frota CS, Gomes FU, et al. Cytomegalovirus infection in inflammatory bowel disease is not associated with worsening of intestinal inflammatory activity. PLoS One. 2014;9(11):e111574.
Beaugerie L, Ngô Y, Goujard F, Gharakhanian S, Carbonnel F, Luboinski J, et al. Etiology and management of toxic megacolon in patients with human immunodeficiency virus infection. Gastroenterology. 1994;107(3):858-63.
Goodgame RW. Gastrointestinal cytomegalovirus disease. Annals of Internal Medicine. 1993;119(9):924-35.
Wexner SD, Smithy WB, Trillo C, Hopkins BS, Dailey TH. Emergency colectomy for cytomegalovirus ileocolitis in patients with the acquired immune deficiency syndrome. Diseases of the colon & rectum. 1988;31(10):755-61.
Kaufman HS, Kahn AC, Iacobuzio-Donahue C, Talamini MA, Lillemoe KD, Hamilton SR. Cytomegaloviral enterocolitis. Diseases of the colon & rectum. 1999;42(1):24-30.
Vega R, Bertran X, Menacho M, Domenech E, De Vega VM, Hombrados M, et al. Cytomegalovirus infection in patients with inflammatory bowel disease. The American journal of gastroenterology. 1999;94(4):1053-6.
Berk T, Gordon SJ, Choi HY, Cooper HS. Cytomegalovirus infection of the colon: a possible role in exacerbations of inflammatory bowel disease. American Journal of Gastroenterology. 1985;80(5).
Rafailidis PI, Mourtzoukou EG, Varbobitis IC, Falagas ME. Severe cytomegalovirus infection in apparently immunocompetent patients: a systematic review. Virology journal. 2008;5(1):47.
Cooper HS, Raffensperger EC, Jonas L, Fitts WT. Cytomegalovirus inclusions in patients with ulcerative colitis and toxic dilation requiring colonic resection. Gastroenterology. 1977;72(6):1253-6.
Papadakis KA, Tung JK, Binder SW, Kam LY, Abreu MT, Targan SR, et al. Outcome of cytomegalovirus infections in patients with inflammatory bowel disease. The American journal of gastroenterology. 2001;96(7):2137-42.
Powell RD, Warner NE, Levine RS, Kirsner JB. Cytomegalic inclusion disease and ulcerative colitis: report of a case in a young adult. The American journal of medicine. 1961;30(2):334-40.
Saiki RK, Bugawan TL, Horn GT, Mullis KB, Erlich HA. Analysis of enzymatically amplified beta-globin and HLA-DQ alpha DNA with allele-specific oligonucleotide probes. Nature. 1986;324(6093):163-6.
Hernandez AK, Emmons J, Wimmer DB, Payne DA. Cytomegalovirus-Antigenemia-Positive and Polymerase-Chain-Reaction-Negative Transplant Patient. Laboratory Medicine. 2015;39(6):341-2.
Inokuchi T, Kato J, Hiraoka S, Suzuki H, Nakarai A, Hirakawa T, et al. Long-term follow-up of ulcerative colitis patients treated on the basis of their cytomegalovirus antigen status. World Journal of Gastroenterology: WJG. 2014;20(2):509.
Garrido E, Carrera E, Manzano R, Lopez-Sanroman A. Clinical significance of cytomegalovirus infection in patients with inflammatory bowel disease. World J Gastroenterol. 2013;19(1):17-25.
Roblin X, Pillet S, Berthelot P, Del Tedesco E, Phelip J-M, Chambonnière M-L, et al. Prevalence of cytomegalovirus infection in steroid‐refractory Crohn's disease. Inflammatory bowel diseases. 2012;18(7):E1396-E7.
Dignass A, Eliakim R, Magro F, Maaser C, Chowers Y, Geboes K, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1: definitions and diagnosis. J Crohns Colitis. 2012;6(10):965-90.
Kornbluth A, Sachar DB. Ulcerative colitis practice guidelines in adults: American college of gastroenterology, practice parameters committee. The American journal of gastroenterology. 2010;105(3):501-23.
Mowat C, Cole A, Windsor A, Ahmad T, Arnott I, Driscoll R, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2011;60(5):571-607.