No abstract

No abstract

Background The prevalence of opportunistic infections in individuals with inflammatory bowel disease (IBD) remains relevant. Viral infections are a common cause of systemic inflammation of the digestive tract. Clinically expressed herpes infections are a serious problem, especially for individuals with prolonged immunosuppression. The aim of this study was t o assess the frequency of detection of herpes-6 type with polyps in patients with IBD. Methods 189 patients with IBD, 102 with ulcerative colitis and 87 with Crohn’s disease were examined. Of the number of patients: 98women, 91man. The age of the patients is from 16 to 63 years (mean age 41.4 ± 4.8), out of 189 patients intestinal polyps were identified in 61 patients with a colonoscopy. In addition to standard clinical and endoscopic examinations, disease activity was assessed by indicators of highly sensitive C-reactive protein, homocysteine, vitamin D in blood serum, albumin in urine, calprotectin, lactoferrin and pyruvate kinase in faeces. All patients underwent a serological blood test by ELISA for specific antibodies to herpesvirus type 1–6 IgG/IgM antibodies, as well as avidity, determination of DNA to herpes viruses of types 1–6 species by PCR in blood and mucosal biopsy. Results Among patients with IBD (n = 189), active herpes viruses in the blood were found in 65 patients (34.4%); of them, 39 patients (20.6% (n = 189) and 60%(n = 65),respectively) were diagnosed with monoherpesvirus infections, and 26 (13.7%(n = 189) and 40%(n = 65), respectively) of myxedvirus infections. PCR of the biopsy material was positive in isolation for type 6 herpes virus in 22 cases (11.6% (n = 189) and 33.8% (n = 65)) and in 34 cases (17.9% (n = 189) and 52.3% (n = 65)) a myxedvirus lesion was detected in the tissue (HV6 + EPB, HV6 + CMV), these indicators were detected in patients with intestinal polyps. Although clinical and endoscopic and laboratory indicators of disease activity were significantly higher in patients with mixed tissue lesions (p˂0.05), the level of faecal pyruvate kinase was higher in patients with polyps, indicating a negative effect of herpes type 6 on the course of inflammatory bowel diseases. At the same time, no significant differences were found between patients with ulcerative colitis and Crohn’s disease. Conclusion The frequency of occurrence of herpes type 6 on PCR biopsy in patients with polyps with IBD is more than 91.8% (36.5% in isolation and 55.7% of mixed lesions) and is accompanied by higher rates of faecal pyruvate kinase, which is already an indicator of emerging malignancy. The authors propose the determination of polyps in patients with IBD HV6 by PCR biopsy of intestinal tissue.

Background The prevalence of opportunistic infections in individuals with inflammatory bowel disease (IBD) remains relevant. Viral infections are a common cause of systemic inflammation of the digestive tract. Clinically expressed herpes and parvovirus infections are a serious problem, especially for people with prolonged immunosuppression. The aim of the study was t o assess the incidence of certain herpes and parvovirus infections in patients with IBD. Methods In total, 189 patients with IBD, 102 with ulcerative colitis and 87 with Crohn’s disease were examined. Of the number of patients: 98 women, 91man. The age of patients is from 16 to 63 years (mean age 41.4 ± 4.8). In addition to a standard examination, disease activity was assessed by indicators of highly sensitive C-reactive protein, homocysteine, vitamin D in blood serum, albumin in urine, calprotectin and lactoferrin in faeces. All patients underwent serological blood tests by ELISA for specific antibodies to herpes viruses and IgG/IgM antibodies to parvovirus B19, determination of DNA to herpes simplex viruses of types 1-2,6(HSV1-2?HSV6), Epstein–Barr (EBV}, cytomegalovirus (CMV), herpes zoster (HZV) by PCR in blood and mucosal biopsy, and also avidity. Results Among patients with IBD, active infections (herpes and parvoviruses) in the blood occurred in 81 patients (42.8%); of them, 39 patients (20.6%) were diagnosed with monoherpesvirus infections, in 16 patients parvovirus (8.4%), and in 26 (13.8%) cases, active mixed viral infections were detected. In 79 cases (41.7%) of PCR biopsy material was positive for isolated infection: 36 cases (19%) of CMV, 21 cases (11.1%) of EBV, 22 cases (11.6%) of HSV6. Tissue viral infection was found in 34 patients (17.9%). Clinical endoscopic and laboratory indicators of activity in IBD were significantly higher in patients with active viral infections (p ˂ 0.05), which indicates the negative effect of chronic active herpes and parvovirus infections on the course of inflammatory bowel diseases. However, significant differences between patients with ulcerative colitis and Crohn’s disease were not detected. Conclusion The frequency of occurrence of herpes and parvovirus lesions in patients with IBD in the blood is more than 42.8%, isolated infection in the tissue in 41.7%, and mixed infection in 17.9% of the number of patients. The clinical endoscopic picture, as well as laboratory data indicate a more severe course of diseases in the presence of these infections.