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KMID : 1188320140080060643
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Gut and Liver
2014 Volume.8 No. 6 p.643 ~ p.647
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Long-Term Outcomes of Cytomegalovirus Reactivation in Patients with Moderate to Severe Ulcerative Colitis: A Multicenter Study
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Kim You-Sun
Kim Young-Ho
Kim Joo-Sung
Jeong Seong-Yeon
Park Soo-Jeong
Cheon Jae-Hee
Ye Byong-Duk
Jung Sung-Ae
Park Young-Sook
Choi Chang-Hwan
Kim Kyeung-Ok
Jang Byung-Ik
Han Dong-Soo
Yang Suk-Kyun
Kim Won-Ho
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Abstract
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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.
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KEYWORD
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Colitis, ulcerative, Cytomegalovirus, Ganciclovir, Colectomy
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