Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Infectious Disease, School of Medicine, Ziaeian hospital, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2024 May 1;27(5):277-286. doi: 10.34172/aim.2024.40.
Human cytomegalovirus (HCMV) is classified within the order and is prevalent in 50%‒80% of the general population. Most carriers experience this infection without noticeable clinical symptoms. HCMV causes a lifelong latent infection that can be reactivated due to immune disorders and inflammation. The reactivation of HCMV becomes particularly significant when it coincides with inflammatory bowel disease (IBD). While cytomegalovirus (CMV) colitis in IBD patients was identified years ago, the role of CMV in triggering flare-ups, acute severe colitis, treatment resistance, and other outcomes in IBD patients experiencing CMV reactivation remains a subject of ongoing debate. In this review, we aim to address an updated insight into aspects related to the CMV colitis in IBD patients including epidemiology, risk factors, clinical features, diagnostic tests, histology, place of immunosuppressants and indications for antiviral treatment. We suggest for personalized and thorough assessment based on the disease phase and colitis severity when prescribing drugs to these patients. Furthermore, we emphasize the importance of regular patient follow-up to monitor drug side effects, ensuring treatment success, and minimizing the risk of colectomy.
人巨细胞病毒（HCMV）属于疱疹病毒目，在 50%‒80%的普通人群中普遍存在。大多数感染者没有明显的临床症状。HCMV 引起终身潜伏感染，由于免疫紊乱和炎症，可能会再次激活。当 HCMV 再激活与炎症性肠病（IBD）同时发生时，情况尤其严重。虽然多年前就已经发现了 IBD 患者的巨细胞病毒（CMV）结肠炎，但 CMV 在触发 IBD 患者 CMV 再激活时的发作、急性重度结肠炎、治疗抵抗和其他结果中的作用仍存在争议。在这篇综述中，我们旨在提供与 IBD 患者 CMV 结肠炎相关的方面的最新见解，包括流行病学、危险因素、临床特征、诊断测试、组织病理学、免疫抑制剂的应用和抗病毒治疗的适应证。我们建议根据疾病阶段和结肠炎的严重程度个体化、全面地评估这些患者，以开具药物。此外，我们强调定期对患者进行随访，以监测药物的副作用，确保治疗成功，并将结肠切除术的风险降到最低。
