The prevalence and clinical significance of cytomegalovirus infection is reportedly high in patients with refractory inflammatory bowel disease but is unknown in unselected patients with active disease.
Professor Bouhnik and colleagues in Paris, France studied the presence and significance of cytomegalovirus infection in patients admitted for active inflammatory bowel disease.
The researchers analyzed anti-cytomegalovirus antibodies, cytomegalovirus viremia and antigenemia and cytomegalovirus inclusions.
The investigators performed cytomegalovirus immunochemistry staining on ileocolonic biopsies.
The research team included a total of 64 patients (ulcerative colitis, n = 23; Crohn's disease, n = 41) in the study.
Out of these, 18 had been on high-dose oral steroids and 11 on immunosuppressants.
| Blood or urine cytomegalovirus replication markers were found in 6% of patients, all of whom had ulcerative colitis|
|Alimentary Pharmacology and Therapeutics|
The researchers found that anti-cytomegalovirus IgG and IgM were positive in 66% and 5% of patients respectively.
In addition, the research team found blood or urine cytomegalovirus replication markers in 6% of patients, all of whom had ulcerative colitis.
3 patients had cytomegalovirus viremia and received anti-viral treatment with ganciclovir.
The researchers noted that only 1 of these patients had cytomegalovirus antigenemia and also associated biopsy-proven cytomegalovirus colitis, probably as a primary cytomegalovirus infection.
This patient is the only one who benefited from anti-viral therapy.
Prof Bouhnik concluded, "Cytomegalovirus infection is infrequent in in-patients with active inflammatory bowel disease."
"Systematic search of cytomegalovirus replication markers should not be performed."
"Isolated viremia without associated antigenemia or direct demonstration of cytomegalovirus in ileocolonic biopsies does not warrant anti-viral therapy."