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Intestinal cytomegalovirus infection in patients hospitalized for exacerbation of inflammatory bowel disease: a 10-year tertiary referral center experience.

Published on Jun 1, 2015in European Journal of Gastroenterology & Hepatology2.20
· DOI :10.1097/MEG.0000000000000361
Annika Gauss7
Estimated H-index: 7
,
Simon Rosenstiel1
Estimated H-index: 1
+ 6 AuthorsAnna Zawierucha3
Estimated H-index: 3
Cite
Abstract
Abstract This 10-year retrospective cohort study aims to determine the prevalence and risk factors of cytomegalovirus (CMV) infection in inpatients with exacerbated inflammatory bowel disease (IBD). All patients admitted to the Department of Gastroenterology of the University Hospital Heidelberg for IBD exacerbation between January 2004 and June 2013 were enrolled. To identify the risk factors of CMV infection, infected individuals were compared with those with excluded infection. Among 297 patients with exacerbated IBD, 21 had confirmed CMV infection and 79 had excluded CMV infection, whereas the remaining patients had not been sufficiently tested for CMV. Taking into account only sufficiently tested individuals, the prevalence of CMV infection was 22.7% in ulcerative colitis and 16.0% in Crohn's disease. The occurrence of CMV infection was associated with the following variables at admission: age of 30 years or more [odds ratio (OR) 14.29; P=0.004], disease duration less than 60 months (OR 7.69; P=0.011), a blood leukocyte count less than 11/nl (OR 4.49; P=0.041), and immunosuppressive therapy (OR 6.73; P=0.0129). CMV-positive patients remained in the hospital longer than noninfected patients (P=0.0009). In the CMV-positive cohort, a 66-year-old woman died of CMV pneumonia and sepsis, whereas there was no death in the CMV-negative cohort. Immunuosuppressive therapy and age older than 30 years were identified as the main risk factors for the development of CMV infection in exacerbated IBD. Because of the risk of death, diagnostics of CMV infection should especially be initiated in older patients on immunosuppressive therapy.
  • References (20)
  • Citations (16)
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References20
Newest
Published on Apr 1, 2014in Alimentary Pharmacology & Therapeutics7.73
M. Delvincourt1
Estimated H-index: 1
,
Anthony Lopez10
Estimated H-index: 10
+ 9 AuthorsXavier Roblin30
Estimated H-index: 30
(University of Lyon)
Summary Background Consequences of latent cytomegalovirus (CMV) infection reactivation on inflammatory bowel disease (IBD) flare, as a flare-worsening factor or simple bystander, are debated. Impact of anti-viral treatment on IBD course is poorly known. Aim To assess the impact of CMV reactivation on patients hospitalised for IBD flare and the effect of anti-viral treatment on IBD flare in patients with CMV reactivation. Methods First, a population of UC patients from Saint-Antoine hospital, in ...
Published on Mar 1, 2014in International Journal of Infectious Diseases3.54
Rinaldo Focaccia Siciliano10
Estimated H-index: 10
(USP: University of São Paulo),
Jussara Bianchi Castelli13
Estimated H-index: 13
(USP: University of São Paulo)
+ 2 AuthorsTânia Mara Varejão Strabelli14
Estimated H-index: 14
(USP: University of São Paulo)
Summary Objectives Cytomegalovirus (CMV) is a ubiquitous virus and its reactivation may lead to CMV end-organ disease (CMV EOD) in immunocompromised patients and also in immunocompetent patients when they are critically ill. We aimed to investigate the frequency and the clinical features of proven CMV EOD in previously non-immunosuppressed patients admitted to our institution. Methods From January 2000 to March 2013, the records of all patients with a histopathological diagnosis of CMV EOD at ou...
Published on Jan 1, 2014in World Journal of Gastroenterology3.41
Uri Kopylov29
Estimated H-index: 29
,
Noa Eliakim-Raz1
Estimated H-index: 1
+ 3 AuthorsLior H. Katz16
Estimated H-index: 16
AIM: To evaluate the impact of antiviral treatment on cytomegalovirus (CMV)-positive ulcerative colitis patients. METHODS: We performed a systematic review and meta-analysis (MA) of comparative cohort and case-control studies published between January 1966 and March 2013. Studies focusing on colectomy series and studies including only less than 3 patients in the treated or non-treated arm were excluded. The primary outcome was colectomy within 30 d of diagnosis. Secondary outcomes included colec...
Published on Jan 1, 2013in World Journal of Gastroenterology3.41
Elena Garrido6
Estimated H-index: 6
,
Elisa Carrera2
Estimated H-index: 2
+ 1 AuthorsAntonio López-Sanromán17
Estimated H-index: 17
Cytomegalovirus (CMV) infection is common in humans. The virus then enters a “latency phase” and can reactivate to different stimuli such as immunosuppression. The clinical significance of CMV infection in inflammatory bowel disease is different in Crohn’s disease (CD) and ulcerative colitis (UC). CMV does not interfere in the clinical course of CD. However, CMV reactivation is frequent in severe or steroid-resistant UC. It is not known whether the virus exacerbates the disease or simply appears...
Published on Jul 1, 2012in International Journal of Infectious Diseases3.54
Antonio Cascio32
Estimated H-index: 32
(UNIME: University of Messina),
Chiara Iaria14
Estimated H-index: 14
(UNIME: University of Messina)
+ 1 AuthorsWalter Fries28
Estimated H-index: 28
(UNIME: University of Messina)
Summary Background Inflammatory bowel disease (IBD) patients are at increased risk of cytomegalovirus (CMV) reactivation, and although CMV pneumonia may be a fatal disease in IBD patients, little information is available on this issue. The objectives of this study were to identify risk factors for the development of CMV pneumonia in IBD patients and to find useful information to better manage this potentially fatal complication. Methods A computerized search without language restrictions was con...
Published on Jul 1, 2012in Digestive and Liver Disease3.04
Sylvie Pillet15
Estimated H-index: 15
(University of Lyon),
Bruno Pozzetto39
Estimated H-index: 39
(University of Lyon)
+ 2 AuthorsXavier Roblin30
Estimated H-index: 30
(University of Lyon)
Cytomegalovirus is a deoxyribonucleic acid virus that infects a large part of the human population; after primary infection, it develops a latent state and can be reactivated, notably after a decrease in host immune defences. In patients with inflammatory bowel diseases, cytomegalovirus is frequently involved, either as an agent of colitis or through local asymptomatic reactivation. Due to the immune context of inflammatory bowel diseases and to the immunosuppressive therapies that are used to t...
Published on Nov 1, 2011in The American Journal of Gastroenterology10.24
Xavier Roblin30
Estimated H-index: 30
(University of Lyon),
Sylvie Pillet15
Estimated H-index: 15
(University of Lyon)
+ 7 AuthorsBruno Pozzetto39
Estimated H-index: 39
(University of Lyon)
Cytomegalovirus Load in Inflamed Intestinal Tissue Is Predictive of Resistance to Immunosuppressive Therapy in Ulcerative Colitis
Published on Sep 1, 2010in Journal of Medical Virology2.05
Nicolas Lévêque15
Estimated H-index: 15
,
Hedia Brixi-Benmansour2
Estimated H-index: 2
+ 7 AuthorsMarie-Danièle Diebold18
Estimated H-index: 18
Although numerous reports have described inflammatory bowel diseases (IBDs) complicated with cytomegalovirus (CMV) infection, the virus participation as an exacerbating factor remains unclear. The aim of this study was thus to clarify the clinical significance of CMV infection complicating exacerbation and to correlate CMV detection with various characteristics in IBD patients. Sixty-seven colonic biopsies obtained from 53 patients admitted for IBD exacerbation were retrospectively analyzed by r...
Published on Jun 1, 2009in Journal of Crohns & Colitis7.83
Jean-François Rahier15
Estimated H-index: 15
,
Fernando Magro30
Estimated H-index: 30
(University of Porto)
+ 20 AuthorsJean-Frederic Colombel126
Estimated H-index: 126
(Mount Sinai Hospital)
The treatment of inflammatory bowel disease (IBD) has been revolutionised over the past decade by the increasing use of immunomodulators, mainly azathioprine (AZA)/6-mercaptopurine (6-MP) and methotrexate (MTX), together with the advent of biological therapy. Immunomodulators are being used more often and earlier in the course of the disease.1 The introduction of biologic agents, especially inhibitors of the key proinflammatory cytokine, tumor necrosis factor alpha (TNF-α) initiated a new therap...
Published on Feb 1, 2007in The American Journal of Gastroenterology10.24
Katsuyoshi Matsuoka29
Estimated H-index: 29
(Keio: Keio University),
Yasushi Iwao29
Estimated H-index: 29
+ 11 AuthorsToshifumi Hibi70
Estimated H-index: 70
(Keio: Keio University)
Cytomegalovirus Is Frequently Reactivated and Disappears Without Antiviral Agents in Ulcerative Colitis Patients
Cited By16
Newest
Published on 2019in Gut17.94
Christopher A. Lamb18
Estimated H-index: 18
(Newcastle University),
Nicholas A. Kennedy25
Estimated H-index: 25
(University of Exeter)
+ 7 AuthorsChristian Philipp Selinger3
Estimated H-index: 3
(University of Leeds)
Ulcerative colitis and Crohn’s disease are the principal forms of inflammatory bowel disease. Both represent chronic inflammation of the gastrointestinal tract, which displays heterogeneity in inflammatory and symptomatic burden between patients and within individuals over time. Optimal management relies on understanding and tailoring evidence-based interventions by clinicians in partnership with patients. This guideline for management of inflammatory bowel disease in adults over 16 years of age...
Published on 2019in Scandinavian Journal of Gastroenterology2.15
Shin Ju Oh2
Estimated H-index: 2
(Kyung Hee University),
Chang Kyun Lee18
Estimated H-index: 18
(Kyung Hee University)
+ 5 AuthorsHyo Jong Kim25
Estimated H-index: 25
(Kyung Hee University)
AbstractBackground and aims: The impact of cytomegalovirus (CMV) colitis on long-term outcomes of ulcerative colitis (UC) flares remains controversial.Methods: A total of 257 UC patients with moder...
Published on Mar 7, 2019in Gastroenterology Research and Practice1.82
Ali Y. Fakhreddine (Scripps Health), Catherine Frenette14
Estimated H-index: 14
(Scripps Health)
+ 0 AuthorsGauree G. Konijeti (Scripps Health)
Human cytomegalovirus (CMV) is a ubiquitous Herpesviridae virus with a wide spectrum of pathology in humans. Host immunity is a major determinant of the clinical manifestation of CMV and can vary widely in the gastroenterology and hepatology practice setting. Immunocompetent patients generally develop a benign, self-limited mononucleosis-like syndrome whereas gastrointestinal tissue-invasive disease is more frequently seen in immunocompromised and inflammatory bowel disease patients. Additionall...
Published on Feb 1, 2019in International Journal of Colorectal Disease2.64
Lea I. Kredel5
Estimated H-index: 5
(Humboldt University of Berlin),
Pamela Mundt1
Estimated H-index: 1
(Charité)
+ 5 AuthorsJan C. Preiß1
Estimated H-index: 1
(Humboldt University of Berlin)
Purpose The optimal method for detecting CMV colitis in patients with inflammatory bowel disease (IBD) has not been established. We wanted to investigate which diagnostic test would be most accurate when defining CMV colitis rather by the further clinical course than by using another diagnostic modality.
Published on Feb 1, 2019in Current Infectious Disease Reports2.75
Anat Yerushalmy-Feler3
Estimated H-index: 3
(Tel Aviv Sourasky Medical Center),
Anat Yerushalmy-Feler (Tel Aviv Sourasky Medical Center)+ 0 AuthorsShlomi Cohen10
Estimated H-index: 10
(Tel Aviv Sourasky Medical Center)
Purpose of Review Cytomegalovirus (CMV) colitis is a relatively common end-organ infectious complication in immunocompromised hosts which negatively affects clinical outcomes. This paper presents the contemporary approaches to the diagnosis and management of CMV colitis and discusses some of the controversies of this condition, focusing on methods of diagnosis.
Published on Apr 3, 2018in Scandinavian Journal of Gastroenterology2.15
Edyta Zagórowicz9
Estimated H-index: 9
,
Agnieszka Przybysz1
Estimated H-index: 1
+ 3 AuthorsAndrzej Mroz5
Estimated H-index: 5
AbstractObjectives: Cytomegalovirus (CMV) often reactivates in ulcerative colitis (UC). In diagnostics, along with immunohistochemistry (IHC) of colonic biopsies, blood CMV polymerase chain reaction (PCR) is gaining increasing application. We aimed to assess agreement between the density of infected colonic cells by IHC and the viral load in the blood by PCR.Material and methods: We retrospectively identified patients with active UC or indeterminate colitis in whom blood CMV PCR had been perform...
Published on Apr 1, 2018in Current Gastroenterology Reports
Anat Yerushalmy-Feler3
Estimated H-index: 3
(TAU: Tel Aviv University),
Anat Yerushalmy-Feler1
Estimated H-index: 1
(TAU: Tel Aviv University)
+ 0 AuthorsShlomi Cohen (TAU: Tel Aviv University)
Purpose of Review Patients with inflammatory bowel disease (IBD) are predisposed to infections. Cytomegalovirus (CMV) colitis in adult IBD patients, particularly ulcerative colitis (UC), is related to severe or steroid-refractory disease. The aim of this review is to summarize the data on the prevalence and role of CMV colitis in children with IBD.
Published on Dec 1, 2017in BMC Gastroenterology2.25
Meng-Tzu Weng6
Estimated H-index: 6
(NTU: National Taiwan University),
Chien-Chih Tung4
Estimated H-index: 4
(NTU: National Taiwan University)
+ 6 AuthorsShu-Chen Wei23
Estimated H-index: 23
(NTU: National Taiwan University)
Colitis is exacerbated in patients with concurrent cytomegalovirus (CMV) infection and inflammatory bowel disease (IBD). We assessed the prevalence and clinical features of CMV colitis in hospitalized IBD patients. A retrospective study reviewed the data from January 1, 1998 through December 31, 2013 compiled at the National Taiwan University Hospital. The CMV colitis patients’ demographic data, clinical information, treatment regimens, pathologic findings, and outcome were analyzed. A total of ...
Published on May 1, 2017in The Korean Journal of Internal Medicine2.71
Sung Chul Park10
Estimated H-index: 10
(Kangwon National University),
Yoon Mi Jeen1
Estimated H-index: 1
,
Yoon Tae Jeen25
Estimated H-index: 25
(KU: Korea University)
Published on May 1, 2017in Inflammatory Bowel Diseases4.00
Hong Yang32
Estimated H-index: 32
(Peking Union Medical College Hospital),
Weixun Zhou3
Estimated H-index: 3
(Peking Union Medical College Hospital)
+ 9 AuthorsDong Wu2
Estimated H-index: 2
(Peking Union Medical College Hospital)
View next paperInfection with cytomegalovirus in patients with inflammatory bowel disease: prevalence, clinical significance and outcome