Department of Pediatric Gastroenterology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan.
Liver Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan.
Viruses. 2024 Feb 23;16(3):346. doi: 10.3390/v16030346.
Cytomegalovirus (CMV) is a potential pathogen that causes gastrointestinal (GI) tract diseases regardless of host immunity. In contrast to immunocompromised individuals, immunocompetent patients lack a comprehensive overview of the gastrointestinal manifestations. This study aims to provide a comprehensive summary of the current evidence regarding presentations, diagnostics, management, risk assessment, and outcomes in immunocompetent patients with CMV GI disease. A thorough literature search of English publications up to April 2022 was conducted across electronic databases to identify relevant articles, with eligible case series selected for detailed analysis. The majority of immunocompetent patients affected by CMV GI disease are typically elderly, critically ill, or burdened with comorbidities that compromise immunity. Clinical presentations range from subtle symptoms to severe surgical conditions, including instances of mortality. Specific clinical presentations, blood test results, or endoscopic features are lacking, necessitating reliance on histopathological tests such as immunohistochemistry staining for diagnosis. While antiviral therapy may offer benefits in improving outcomes, careful individual assessment is warranted due to diverse comorbidities and potential side effects. Mortality rates vary considerably based on underlying medical conditions and therapeutic approaches. It is imperative for clinicians to maintain vigilance for CMV GI disease among high-risk groups, despite their baseline immunocompetence, in order to enhance clinical outcomes.
巨细胞病毒（CMV）是一种潜在的病原体，无论宿主的免疫状态如何，均可引起胃肠道（GI）疾病。与免疫功能低下的个体不同，免疫功能正常的患者缺乏对胃肠道表现的全面了解。本研究旨在全面总结目前关于免疫功能正常的 CMV GI 疾病患者的临床表现、诊断、治疗、风险评估和结局的证据。对截至 2022 年 4 月的英文文献进行了全面的电子数据库文献检索，以确定相关文章，并对合格的病例系列进行详细分析。受 CMV GI 疾病影响的大多数免疫功能正常的患者通常是老年人、重症患者或患有影响免疫的合并症。临床表现从轻微的症状到严重的手术情况不等，包括死亡病例。缺乏特定的临床表现、血液检查结果或内镜特征，需要依靠组织病理学检查，如免疫组织化学染色进行诊断。虽然抗病毒治疗可能有助于改善结局，但由于存在多种合并症和潜在的副作用，需要进行仔细的个体评估。死亡率差异很大，取决于基础医疗状况和治疗方法。对于临床医生来说，至关重要的是，即使患者的基线免疫功能正常，也要警惕高危人群中的 CMV GI 疾病，以提高临床结局。
