Review article: cytomegalovirus and inflammatory bowel disease.

Abstract:

BACKGROUND:The association between ulcerative colitis and cytomegalovirus (CMV) has been recognised for over 50 years; and the role of CMV in ulcerative colitis in general, and steroid resistance in particular, remains a topic of ongoing controversy. The outcome for patients with CMV reactivation appears worse than that for patients without reactivation, but it is not entirely clear whether CMV is a contributor or a bystander and if treatment with anti-virals alters the course of inflammatory bowel disease (IBD). AIM:To review the role of CMV associated with IBD, including epidemiology, clinical features, diagnosis and management strategies. METHODS:By reviewing literature available on CMV associated with IBD in adult patients. A PubMed literature search was performed using the following terms individually or in combination: CMV colitis, cytomegalovirus colitis, IBD and CMV, CMV treatment. RESULTS:Cytomegalovirus reactivation is common in patients with severe colitis, with a reported prevalence of 4.5-16.6%, and as high as 25% in patients requiring colectomy for severe colitis. The outcome for this group of patients appears worse than that for patients without reactivation; however, reported remission rates following treatment with anti-viral therapy are as high as 71-86%. CONCLUSIONS:Evidence, although not conclusive, supports testing for CMV colonic disease in cases of moderate to severe colitis, by processing biopsies for haematoxylin and eosin staining with immunohistochemistry and/or, CMV DNA real-time polymerase chain reaction; and if present treating with ganciclovir.

journal_name

Aliment Pharmacol Ther

authors

Sager K,Alam S,Bond A,Chinnappan L,Probert CS

doi

10.1111/apt.13124

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

725-33

issue

8

eissn

0269-2813

issn

1365-2036

journal_volume

41

pub_type

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