Cytomegalovirus infection associated with inflammatory bowel disease

Siegmund, Britta

doi:10.1016/s2468-1253(16)30159-5

Cited by 32 publications

(38 citation statements)

References 59 publications

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“…3,4 Patients with silent chronic CMV infection may develop CMV-mediated colitis, without systemic manifestations of CMV infection, in the context of an IBD flare. 6 Conversely, we observed that half of the patients with systemic CMV primary infection had intestinal manifestations considered as clinically active IBD at clinical onset of SVI, suggesting that primary CMV infection may provoke or worsen intestinal inflammation. Most of the patients with systemic signs of reactivation of CMV infection had clinically active IBD at clinical onset of SVI, suggesting at least a partial role of IBD activity in the pathogenesis of infection.…”

Section: Discussionmentioning

confidence: 76%

“…[2][3][4] Focusing on viral infections, patients with IBD may first develop serious viral infections (SVIs) that are not related to IBD activity or treatment. They may also develop SVI triggered by intestinal inflammation, mainly cytomegalovirus (CMV) colitis, 5,6 and Epstein-Barr Virus (EBV) systemic reactivation. 7 Finally, they may develop SVI attributable to the immunosuppressive action of IBD drugs, knowing that the magnitude of this effect may substantially differ among drugs.…”

Section: Introductionmentioning

confidence: 99%

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Increased incidence of systemic serious viral infections in patients with inflammatory bowel disease associates with active disease and use of thiopurines

et al. 2020

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Background The magnitude and drivers of the risk of serious viral infections in Inflammatory Bowel diseases (IBD) are unclear. Objective The objective of this study was to assess the incidence and risk factors for systemic serious viral infections in IBD patients. Methods Using MICISTA, a database detailing prospective characteristics and complications of IBD, we identified patients that were followed for IBD in 2005–2014 outside the context of organ transplantation, HIV infection or chronic viral hepatitis. We estimated incidences of systemic serious viral infections, defined by the need for hospitalization or permanent organ damage. Standardized incidence ratios (SIRs) were calculated using the French hospital database. We performed a case-control study nested in MICISTA for assessing the role of exposure to IBD drugs and IBD clinical activity in the risk of developing infection. Results We identified 31 patients with serious viral infections among 2645 patients followed for 15,383 person-years. We observed 13 cases of cytomegalovirus, 10 Epstein–Barr virus, 5 varicella zoster virus and 3 herpes simplex virus infections. No deaths occurred. The incidence rate of infections in patients with IBD was 2.02/1000 person-years, and the SIR was 3.09 (95% confidence interval (CI), 1.98–4.20; p = 0.0002) in the study population. By multivariate analysis, increased risk of infection was associated with exposure to thiopurines (odds ratio (OR), 3.48; 95% CI, 1.36–8.90; p = 0.009), and clinically active IBD at onset of infection (OR, 3.35; 95% CI, 1.23–9.23; p = 0.02). Conclusions The incidence of systemic serious viral infections in patients with IBD is tripled compared to general population. Clinically active IBD and exposure to thiopurines are the main drivers of the risk.

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Increased incidence of systemic serious viral infections in patients with inflammatory bowel disease associates with active disease and use of thiopurines

et al. 2020

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“…Nach wie vor bestehen Sicherheitsbedenken, die auch durch ein ( Aufgrund der bislang uneinheitlichen Datenlage sollte eine CMV-Diagnostik nur dann erfolgen, wenn bei CMV-Nachweis eine antivirale Therapie sinnvoll erscheint. Diese Entscheidung ist in erster Linie von der Ausprägung der klinischen Symptomatik bestimmt [331,537].…”

Section: Hintergrundunclassified

Aktualisierte S3-Leitlinie Colitis ulcerosa der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)

2018

Z Gastroenterol

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This guideline provides evidence-based key recommendations for diagnosis and treatment of ulcerative colitis and upgrades the 2011 version. The guideline was developed by an interdisciplinary team of gastroenterologists, surgeons, pathologists, nutrition experts, and patient support groups under the auspice of the German Society for Gastroenterology and Metabolic Diseases. The guideline used structural S3 consensus-based methodology and includes statements on clinical practice, prevention, infectiological problems, surgery and nutrition.

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“…Due to the currently inconsistent evidence, CMV diagnostics should only be carried out if antiviral therapy is considered useful upon detection of CMV. This decision depends largely on the severity of clinical symptoms [331,537].…”

Section: Introductionmentioning

confidence: 99%

Updated S3-Guideline Ulcerative Colitis. German Society for Digestive and Metabolic Diseases (DGVS)

2019

Z Gastroenterol

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Cytomegalovirus infection associated with inflammatory bowel disease

Cited by 32 publications

References 59 publications

Increased incidence of systemic serious viral infections in patients with inflammatory bowel disease associates with active disease and use of thiopurines

Increased incidence of systemic serious viral infections in patients with inflammatory bowel disease associates with active disease and use of thiopurines

Aktualisierte S3-Leitlinie Colitis ulcerosa der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)

Updated S3-Guideline Ulcerative Colitis. German Society for Digestive and Metabolic Diseases (DGVS)

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