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Cytomegalovirus in Inflammatory Bowel Disease - Clinical Relevance.

Viswanath Reddy Donapati, , 1Viswanath Reddy Donapati , 2G. R. Srinivas Rao , 3Y , Rami Reddy

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Gastroenterology International 4(1-2):p 5-19, . | DOI:
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Viswanath Reddy Donapati, G. R. Srinivas Rao, Y Rami Reddy. Cytomegalovirus in Inflammatory Bowel Disease - Clinical
Relevance. Gastroenterology International. 2018;3(1-2):5-11.
 

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Abstract

Background: Cytomegalovirus is a common and self-limiting infection in general population, but in immunocompromised states it has been implicated in severe complications like pneumonia and colitis. It could also be an innocent bystander(coloniser) in colon. In Inflammatory bowel disease there has been an association with severe colitis and flares of disease,with a reported prevalence of 4.5–16.6%, and as high as 25% in patientsrequiring colectomy for severe colitis. The role of CMV in the deterioration of the IBD disease is still debatable. There is also no global consensus in defining this entity. The clinical relevance of the presence of CMV in IBD patients is our question-whether it is a bystander or clinically significant. Aim: To analyse the clinical relevance of Cytomegalovirus in patients with inflammatory bowel disease, including epidemiology, clinical features, diagnosis and management options. Methods: Literature search was made using Pubmed, EMBASE and the Cochrane resources with the search words: CMV in Inflammatory Bowel disease, cytomegalovirus colitis, CMV treatment. Results: Cytomegalovirus infection is common in patients with Inflammatory Bowel Disease. CMV disease and CMV reactivation is common in patients with severe colitis, with a prevalence of 4.5–16.6%, and upto 25% in patients with severe colitis requiring colectomy. The clinical outcome of patients with reactivation is poorer compared to those without reactivation. However, 71-86% of patients who underwent treatment with antivirals showed disease remission. Conclusions: From the literature review, we can infer that, testing for CMV should be considered in patients with flare of disease having moderate to severe activity, by doing biopsies for microscopic evidence of CMV activity, Immunohistochemistry, tissue for Real time Polymerase Chain reaction. Ganciclovir treatment showed good results in these group of patients. Key Words: Cytomegalovirus infection, Cytomegalovrus Disease, Inflammatory Bowel Disease, Flare, Severe Colitis, Steroid Refractory Colitis, Clinical relevance.

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  • Viswanath Reddy Donapati,
    ,
  • 1Viswanath Reddy Donapati
    ,
  • 2G. R. Srinivas Rao
    ,
  • 3Y
    ,
  • Rami Reddy
    ,
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Viswanath Reddy Donapati, G. R. Srinivas Rao, Y Rami Reddy. Cytomegalovirus in Inflammatory Bowel Disease - Clinical
Relevance. Gastroenterology International. 2018;3(1-2):5-11.
 

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