Qin Yafei, Wang Grace, Kong Dejun, Li Guangming, Wang Hongda, Qin Hong, Wang Hao
Department of General Surgery, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin 300052, China.
Tianjin General Surgery Institute, Tianjin Medical University General Hospital, 154 Anshan Road, Heping District, Tianjin 300052, China.
Diagnostics (Basel). 2021 Oct 21;11(11):1952. doi: 10.3390/diagnostics11111952.
Cytomegalovirus (CMV) infection is associated with exacerbation of disease activity in patients with ulcerative colitis (UC). However, the risk factors for CMV reactivation in this population remain debatable. This meta-analysis was performed to identify the risk factors for CMV reactivation in UC patients. PubMed, Cochrane Library, EMBASE, Web of Science, and China National Knowledge Infrastructure were searched from the inception of these databases to 31 August 2021, with the aim of identifying studies that investigated the risk factors of CMV reactivation in UC patients. A quality assessment of the included studies was performed with the Newcastle-Ottawa Scale. The publication bias was assessed respectively via a funnel plot and Egger's regression asymmetry test. The robustness and reliability of each outcome were evaluated by sensitivity analysis. Twenty studies were included in the final meta-analysis, comprising a total of 2099 patients with UC. A significantly higher risk of CMV reactivation was observed in patients with severe UC (OR = 1.465, 95% CI: 1.107 to 1.939, = 0.008), pancolitis (OR = 2.108, 95% CI: 1.586 to 2.800, = 0.0001), older age of UC onset (MD = 6.212, 95% CI: 2.552 to 9.971, = 0.001), as well as use of glucocorticoids (OR = 4.175, 95% CI: 3.076 to 5.666, = 0.001), immunosuppressants (OR = 1.795, 95% CI: 1.289 to 2.501, = 0.001), and azathioprine (OR = 1.444, 95% CI: 1.012 to 2.061, = 0.043). However, infliximab treatment was observed not to increase the occurrence of CMV reactivation in patients who suffered from UC. In contrast, 5-aminosalicylic acid (OR = 0.674, 95% CI: 0.492 to 0.924, = 0.014) was associated with a lower risk of CMV reactivation. Patients with UC should be closely monitored for risk factors of CMV reactivation in order to provide timely diagnosis and antiviral treatment.
巨细胞病毒（CMV）感染与溃疡性结肠炎（UC）患者疾病活动的加剧有关。然而，该人群中CMV再激活的危险因素仍存在争议。本荟萃分析旨在确定UC患者CMV再激活的危险因素。检索了PubMed、Cochrane图书馆、EMBASE、科学网和中国知网，检索时间从这些数据库建立至2021年8月31日，目的是识别调查UC患者CMV再激活危险因素的研究。采用纽卡斯尔-渥太华量表对纳入研究进行质量评估。分别通过漏斗图和Egger回归不对称检验评估发表偏倚。通过敏感性分析评估每个结果的稳健性和可靠性。最终的荟萃分析纳入了20项研究，共2099例UC患者。重度UC患者（OR = 1.465，95%CI：1.107至1.939，P = 0.008）、全结肠炎患者（OR = 2.108，95%CI：1.586至2.800，P = 0.0001）、UC发病年龄较大者（MD = 6.212，95%CI：2.552至9.971，P = 0.001）以及使用糖皮质激素（OR = 4.175，95%CI：3.076至5.666，P = 0.001）、免疫抑制剂（OR = 1.795，95%CI：1.289至2.501，P = 0.001）和硫唑嘌呤（OR = 1.444，95%CI：1.012至2.061,P = 0.043）的患者中，CMV再激活风险显著更高。然而，观察发现英夫利昔单抗治疗不会增加UC患者CMV再激活的发生率。相比之下，5-氨基水杨酸（OR = 0.674，95%CI：0.49至0.924，P = 0.014）与较低的CMV再激活风险相关。应密切监测UC患者CMV再激活的危险因素，以便及时诊断并进行抗病毒治疗。
