Kim You Sun, Kim Young-Ho, Kim Joo Sung, Cheon Jae Hee, Ye Byong Duk, Jung Sung-Ae, Park Young Sook, Choi Chang Hwan, Jang Byung Ik, Han Dong Soo, Yang Suk-Kyun, Kim Won Ho
Department of Internal Medicine, Inje University College of Medicine, Korea.
Hepatogastroenterology. 2012 Jun;59(116):1098-101. doi: 10.5754/hge10217.
BACKGROUND/AIMS: Immunosuppressive therapy in ulcerative colitis (UC) may induce cytomegalovirus (CMV) infection or reactivation in the colonic mucosa and in turn exacerbate UC. However, it is unclear whether colonic inflammation itself affects CMV infection in UC. This prospective study evaluated the prevalence and clinical outcome of CMV infection in patients with new onset UC who have not been exposed to UC medication.
A prospective, multi-center study was conducted in 65 patients with new onset UC. The presence of CMV was evaluated by a serology test and a histopathological examination including immunohistochemical staining. The assessment of clinical outcome was performed based on CMV positivity.
Evidence of CMV infection was found in three (4.5%) patients with UC. Two patients with moderate disease activity improved with 5-aminosalicylate or steroid treatment. One patient with severe active colitis, however, required antiviral therapy.
CMV infection is rare in new onset UC, which suggests that use of immunosuppressive medications is an important risk factor for CMV infection in UC. However, CMV evaluation is necessary for severe active UC, even with new onset of the disease.
背景/目的：溃疡性结肠炎（UC）的免疫抑制治疗可能会诱发结肠黏膜中的巨细胞病毒（CMV）感染或再激活，进而加重UC。然而，尚不清楚结肠炎症本身是否会影响UC中的CMV感染。这项前瞻性研究评估了未接触过UC药物的新发UC患者中CMV感染的患病率和临床结局。
对65例新发UC患者进行了一项前瞻性、多中心研究。通过血清学检测和包括免疫组化染色在内的组织病理学检查评估CMV的存在情况。基于CMV阳性对临床结局进行评估。
在3例（4.5%）UC患者中发现了CMV感染的证据。2例中度疾病活动患者经5-氨基水杨酸或类固醇治疗后病情改善。然而，1例重度活动性结肠炎患者需要抗病毒治疗。
新发UC中CMV感染罕见，这表明使用免疫抑制药物是UC中CMV感染的重要危险因素。然而，即使是新发疾病，对于重度活动性UC也有必要进行CMV评估。
