Szlak Jakub, Magdziak Agnieszka, Mróz Andrzej, Wieszczy-Szczepanik Paulina, Reguła Jaroslaw, Zagórowicz Edyta
Departments of Gastroenterological Oncology.
Microbiology.
Eur J Gastroenterol Hepatol. 2025 Aug 1;37(8):922-929. doi: 10.1097/MEG.0000000000003001. Epub 2025 May 12.
The role of cytomegalovirus (CMV) infection in the course of inflammatory bowel disease is still controversial. We aimed to prospectively evaluate the course of ulcerative colitis in patients with exacerbation, in whom CMV status was examined using immunohistochemistry of bowel biopsies.
In a single centre, we followed-up consecutive patients admitted for moderate or severe ulcerative colitis flare between 2016 and 2019. Colectomies, repeated hospitalisations, major treatment modifications, and quality of life (QoL) were recorded. The relationship between categorical variables was examined with the χ2 statistical test or Fisher's exact test.
Of 84 patients, 16 (19%) were CMV-positive. A Mayo endoscopic score of 3 was more frequent in CMV-positive than CMV-negative patients (81.2 vs. 51.5%; P = 0.048) as was corticosteroid treatment (81.2 vs. 54.4%; P = 0.015). Median follow-up was 2.1 years (range: 0.3-3.6 years). Colectomy was performed in 20 (23.8%) patients, with similar rates in CMV-positive (25%) and CMV-negative patients (23.5%; P = 1.0). Similarly, no differences were found in the frequency of hospitalisation and QoL. The percentage of patients who started biological treatment was higher in the CMV-negative than in the CMV-positive group (58.8 vs. 18.8%; P = 0.005).
CMV infection was present in 19% of consecutive patients hospitalised for ulcerative colitis flare. Corticosteroid treatment and severe endoscopic lesions were observed more often in patients CMV-positive. In the following 2.1 years, the colectomy rate did not differ between patients CMV-positive and CMV-negative. Routine screening for CMV in ulcerative colitis exacerbation is not advisable.
巨细胞病毒（CMV）感染在炎症性肠病病程中的作用仍存在争议。我们旨在前瞻性评估病情加重的溃疡性结肠炎患者的病程，这些患者通过肠道活检免疫组化检测CMV状态。
在单一中心，我们对2016年至2019年间因中度或重度溃疡性结肠炎发作入院的连续患者进行随访。记录结肠切除术、再次住院、主要治疗调整和生活质量（QoL）。分类变量之间的关系采用χ2统计检验或Fisher精确检验进行分析。
84例患者中，16例（19%）CMV阳性。CMV阳性患者中梅奥内镜评分为3分的情况比CMV阴性患者更常见（81.2%对51.5%；P = 0.048），皮质类固醇治疗情况也是如此（81.2%对54.4%；P = 0.015）。中位随访时间为2.1年（范围：0.3 - 3.6年）。20例（23.8%）患者接受了结肠切除术，CMV阳性患者（25%）和CMV阴性患者（23.5%）的切除率相似（P = 1.0）。同样，在住院频率和生活质量方面未发现差异。开始生物治疗的患者百分比在CMV阴性组高于CMV阳性组（58.8%对18.8%；P = 0.005）。
因溃疡性结肠炎发作住院的连续患者中，19%存在CMV感染。CMV阳性患者更常观察到皮质类固醇治疗和严重内镜病变。在随后的2.1年中，CMV阳性和CMV阴性患者的结肠切除率无差异。不建议对溃疡性结肠炎加重患者进行CMV常规筛查。
