Long-term outcomes of cytomegalovirus reactivation in patients with moderate to severe ulcerative colitis: A multicenter study

You Sun Kim, Young Ho Kim, Joo Sung Kim, Seong Yeon Jeong, Soo Jeong Park, Jae Hee Cheon, Byong Duk Ye, Sung Ae Jung, Young Sook Park, Chang Hwan Choi, Kyeung Ok Kim, Byung Ik Jang, Dong Soo Han, Suk Kyun Yang, Won Ho Kim

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22 Citations (Scopus)

Abstract

Background/Aims: Cytomegalovirus (CMV) reactivations are frequently observed in patients with active ulcerative colitis (UC), and ganciclovir therapy is effective in patients with steroid-refractory UC. This study aimed to determine the longterm outcomes of CMV reactivation and the long-term therapeutic efficacy of ganciclovir treatment. Methods: This retrospective multicenter study included a cohort of 72 patients with moderate-to-severe UC who were evaluated for CMV reactivation at the time of their initial UC flare. Colectomy, disease relapse, and the recurrence rate of CMV reactivation were investigated. Results: The mean duration of follow-up for the 72 patients was 43.16±19.78 months (range, 1 to 67 months). The cumulative colectomy (log-rank, p=0.025) and disease flare-up rates (log-rank, p=0.048) were significantly higher in the CMV-positive group. Of the 11 patients who were successfully treated with ganciclovir in the initial treatment, three patients (27.3%) experienced CMV reactivation, and six patients (54.5%) experienced poor outcomes, such as the need for colectomy or a steroid-dependent state. Conclusions: The patients who had CMV-reactivated UC showed poor outcomes at the long-term follow-up, and the long-term efficacy of ganciclovir therapy was marginal. Careful assessment is necessary for patients who exhibit evidence of CMV reactivation.

Original languageEnglish
Pages (from-to)643-647
Number of pages5
JournalGut and liver
Volume8
Issue number6
DOIs
Publication statusPublished - 2014 Nov 1

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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    Kim, Y. S., Kim, Y. H., Kim, J. S., Jeong, S. Y., Park, S. J., Hee Cheon, J., Ye, B. D., Jung, S. A., Park, Y. S., Choi, C. H., Kim, K. O., Jang, B. I., Han, D. S., Yang, S. K., & Kim, W. H. (2014). Long-term outcomes of cytomegalovirus reactivation in patients with moderate to severe ulcerative colitis: A multicenter study. Gut and liver, 8(6), 643-647. https://doi.org/10.5009/gnl13427