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, JaeHee 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

Research output: Contribution to journalArticle

20 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

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Cytomegalovirus
Ulcerative Colitis
Multicenter Studies
Ganciclovir
Colectomy
Steroids
Recurrence
Therapeutics
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Kim, You Sun ; Kim, Young Ho ; Kim, Joo Sung ; Jeong, Seong Yeon ; Park, Soo Jeong ; Cheon, JaeHee ; Ye, Byong Duk ; Jung, Sung Ae ; Park, Young Sook ; Choi, Chang Hwan ; Kim, Kyeung Ok ; Jang, Byung Ik ; Han, Dong Soo ; Yang, Suk Kyun ; Kim, Won Ho. / Long-term outcomes of cytomegalovirus reactivation in patients with moderate to severe ulcerative colitis : A multicenter study. In: Gut and liver. 2014 ; Vol. 8, No. 6. pp. 643-647.
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title = "Long-term outcomes of cytomegalovirus reactivation in patients with moderate to severe ulcerative colitis: A multicenter study",
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.",
author = "Kim, {You Sun} and Kim, {Young Ho} and Kim, {Joo Sung} and Jeong, {Seong Yeon} and Park, {Soo Jeong} and JaeHee Cheon and Ye, {Byong Duk} and Jung, {Sung Ae} and Park, {Young Sook} and Choi, {Chang Hwan} and Kim, {Kyeung Ok} and Jang, {Byung Ik} and Han, {Dong Soo} and Yang, {Suk Kyun} and Kim, {Won Ho}",
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Kim, YS, Kim, YH, Kim, JS, Jeong, SY, Park, SJ, Cheon, J, Ye, BD, Jung, SA, Park, YS, Choi, CH, Kim, KO, Jang, BI, Han, DS, Yang, SK & Kim, WH 2014, 'Long-term outcomes of cytomegalovirus reactivation in patients with moderate to severe ulcerative colitis: A multicenter study', Gut and liver, vol. 8, no. 6, pp. 643-647. https://doi.org/10.5009/gnl13427

Long-term outcomes of cytomegalovirus reactivation in patients with moderate to severe ulcerative colitis : A multicenter study. / Kim, You Sun; Kim, Young Ho; Kim, Joo Sung; Jeong, Seong Yeon; Park, Soo Jeong; Cheon, JaeHee; Ye, Byong Duk; Jung, Sung Ae; Park, Young Sook; Choi, Chang Hwan; Kim, Kyeung Ok; Jang, Byung Ik; Han, Dong Soo; Yang, Suk Kyun; Kim, Won Ho.

In: Gut and liver, Vol. 8, No. 6, 01.11.2014, p. 643-647.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term outcomes of cytomegalovirus reactivation in patients with moderate to severe ulcerative colitis

T2 - A multicenter study

AU - Kim, You Sun

AU - Kim, Young Ho

AU - Kim, Joo Sung

AU - Jeong, Seong Yeon

AU - Park, Soo Jeong

AU - Cheon, JaeHee

AU - Ye, Byong Duk

AU - Jung, Sung Ae

AU - Park, Young Sook

AU - Choi, Chang Hwan

AU - Kim, Kyeung Ok

AU - Jang, Byung Ik

AU - Han, Dong Soo

AU - Yang, Suk Kyun

AU - Kim, Won Ho

PY - 2014/11/1

Y1 - 2014/11/1

N2 - 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.

AB - 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.

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