Long-Term Outcomes of Cytomegalovirus Reactivation in Patients with Moderate to Severe Ulcerative Colitis: A Multicenter Study

Title
Long-Term Outcomes of Cytomegalovirus Reactivation in Patients with Moderate to Severe Ulcerative Colitis: A Multicenter Study
Author(s)
장병익김유순[김유순]김영호[김영호]김주성[김주성]정성연[정성연]박수정[박수정]전재희[전재희]예병덕[예병덕]정성애[정성애]박영숙[박영숙]김경옥
Keywords
INFLAMMATORY-BOWEL-DISEASE; INFECTION; PREVALENCE; CMV
Issue Date
201411
Publisher
EDITORIAL OFFICE GUT & LIVER
Citation
GUT AND LIVER, v.8, no.6, pp.643 - 647
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.
URI
http://hdl.handle.net/YU.REPOSITORY/30480http://dx.doi.org/10.5009/gnl13427
ISSN
1976-2283
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의과대학 > 내과학교실 > Articles
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