Gut Liver.
2014 Nov;8(6):643-647. 10.5009/gnl13427.
Long-Term Outcomes of Cytomegalovirus Reactivation in Patients with Moderate to Severe Ulcerative Colitis: A Multicenter Study
- Affiliations
-
- 1Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea.
- 2Sungkyunkwan University School of Medicine, Seoul, Korea.
- 3Seoul National University College of Medicine, Seoul, Korea. jooskim@snu.ac.kr
- 4Yonsei University College of Medicine, Seoul, Korea.
- 5University of Ulsan College of Medicine, Seoul, Korea.
- 6Ewha Womans University School of Medicine, Seoul, Korea.
- 7Eulji University College of Medicine, Seoul, Korea.
- 8Chung-Ang University College of Medicine, Seoul, Korea.
- 9Yeungnam University College of Medicine, Daegu, Korea.
- 10Hanyang University College of Medicine, Guri, Korea.
- 11IBD Study Group of the Korean Association for the Study of Intestinal Diseases, Seoul, Korea.
- KMID: 2070082
- DOI: http://doi.org/10.5009/gnl13427
Abstract
- BACKGROUND/AIMS
Cytomegalovirus (CMV) reactivations are frequently observed in patients with active ulcerative colitis (UC), and ganciclovir therapy is effective in patients with steroid-refractory UC. This study aimed to determine the long-term outcomes of CMV reactivation and the long-term therapeutic efficacy of ganciclovir treatment.
METHODS
This retrospective multicenter study included a cohort of 72 patients with moderate-to-severe UC who were evaluated for CMV reactivation at the time of their initial UC flare. Colectomy, disease relapse, and the recurrence rate of CMV reactivation were investigated.
RESULTS
The mean duration of follow-up for the 72 patients was 43.16+/-19.78 months (range, 1 to 67 months). The cumulative colectomy (log-rank, p=0.025) and disease flare-up rates (log-rank, p=0.048) were significantly higher in the CMV-positive group. Of the 11 patients who were successfully treated with ganciclovir in the initial treatment, three patients (27.3%) experienced CMV reactivation, and six patients (54.5%) experienced poor outcomes, such as the need for colectomy or a steroid-dependent state.
CONCLUSIONS
The patients who had CMV-reactivated UC showed poor outcomes at the long-term follow-up, and the long-term efficacy of ganciclovir therapy was marginal. Careful assessment is necessary for patients who exhibit evidence of CMV reactivation.
Keyword
MeSH Terms
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Antiviral Agents/*therapeutic use
Case-Control Studies
Cohort Studies
Colectomy/utilization
Colitis, Ulcerative/complications/*drug therapy
*Cytomegalovirus
Cytomegalovirus Infections/complications/*drug therapy
Ganciclovir/*therapeutic use
Humans
Longitudinal Studies
Remission Induction
Retrospective Studies
Severity of Illness Index
Treatment Outcome
*Virus Activation
Antiviral Agents
Ganciclovir
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