Long-Term Outcomes of Cytomegalovirus Reactivation in Patients with Moderate to Severe Ulcerative Colitis: A Multicenter Study.
- Author:
You Sun KIM
1
;
Young Ho KIM
;
Joo Sung KIM
;
Seong Yeon JEONG
;
Soo Jeong PARK
;
Jae Hee CHEON
;
Byong Duk YE
;
Sung Ae JUNG
;
Young Sook PARK
;
Chang Hwan CHOI
;
Kyeung Ok KIM
;
Byung Ik JANG
;
Dong Soo HAN
;
Suk Kyun YANG
;
Won Ho KIM
Author Information
- Publication Type:Original Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
- Keywords: Colitis, ulcerative; Cytomegalovirus; Ganciclovir; Colectomy
- MeSH: 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
- From:Gut and Liver 2014;8(6):643-647
- CountryRepublic of Korea
- Language:English
- 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.
