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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. Dr Sokol and colleagues from France assessed 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. First, a population of UC patients from Saint-Antoine hospital, in flare with positive blood CMV PCR without anti-viral treatment, were compared to matched patients with negative blood CMV PCR in a case–control study. Secondly, a total of 110 hospitalizations between 2003 and 2012 for IBD flare-up with CMV reactivation were identified in 3 French referral centers. Evolution following CMV reactivation diagnosis was compared between patients receiving anti-viral treatment and those who did not. In the case–control study, the team observed no differences between the 2 groups regarding length of hospital stay and colectomy rate. Comparing treated and untreated patients, no differences were observed at inclusion regarding age, gender, IBD type, immunosuppressant, CRP and haemoglobin level. The researchers observed no differences regarding CRP level decrease at 10 days and colectomy rate at 3 months. The team found that anti-viral treatment was associated with lower serum albumin level at inclusion and longer hospitalization. Dr Sokol's team concludes, "CMV reactivation does not appear to alter the course of IBD flare." "CMV treatment does not seem to impact the course of IBD." "These results should be confirmed prospectively."
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