2021
DOI: 10.5217/ir.2020.00055
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High mucosal cytomegalovirus DNA helps predict adverse short-term outcome in acute severe ulcerative colitis

Abstract: course of ulcerative colitis (UC) in up to 25% of cases with a third of these episodes being the presentation of UC. 1,2 Intravenous (IV) steroids remain first-line therapy for ASUC, but only 60% patients respond to IV steroids, with the rest requiring rescue in the form of advanced immunosuppression (infliximab or ciclosporin) or surgery. 3 It is clinically highly relevant to predict steroid nonresponse in order to identify patients who need a change in treatment strategy to improve outcomes, both in the shor… Show more

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Cited by 10 publications
(3 citation statements)
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“…A meta-analysis of 15 studies showed that antiviral treatment benefited only a subgroup of UC patients who were refractory to corticosteroids, whereas no benefit was observed in the overall UC population [ 57 ]. It is proposed that UC patients with high viral load detected by quantitative PCR in colonic mucosa should be a reasonable indication of antiviral treatment from recent studies; the majority of patients with a high viral load had a response to antiviral treatment [ 58 ] and high viral load in colonic mucosa predicted the failure of corticosteroids and short-term risk of colectomy [ 59 ].…”
Section: β-Herpesviruses In Inflammatory Bowel Diseasesmentioning
confidence: 99%
“…A meta-analysis of 15 studies showed that antiviral treatment benefited only a subgroup of UC patients who were refractory to corticosteroids, whereas no benefit was observed in the overall UC population [ 57 ]. It is proposed that UC patients with high viral load detected by quantitative PCR in colonic mucosa should be a reasonable indication of antiviral treatment from recent studies; the majority of patients with a high viral load had a response to antiviral treatment [ 58 ] and high viral load in colonic mucosa predicted the failure of corticosteroids and short-term risk of colectomy [ 59 ].…”
Section: β-Herpesviruses In Inflammatory Bowel Diseasesmentioning
confidence: 99%
“…Nevertheless, to overcome the low sensitivity of IHC staining, colonic CMV PCR test possibly can be considered as a reliable test tool although there is no definite cutoff levels. 12 The study of Jain et al 7 had several limitations; firstly, antiviral treatment was administered in only 7 patients based on IHC staining rather than colonic CMV DNA load. Secondly, the long-term clinical outcomes of patients with colonic CMV DNA load > 2,000 copies/mg were not provided.…”
Section: You Sun Kimmentioning
confidence: 99%
“…DNA load is a strong predictor of steroid resistance. 7,8 The Korean multicenter UC CMV cohort study (median follow-up, 43.35 ± 20.92 months) investigated the long-term prognosis of CMV reactivation. The cumulative colectomy (log-rank P = 0.003) and disease flare-up rates (log-rank P = 0.048) were significantly higher in the CMV-positive group than in the negative group.…”
mentioning
confidence: 99%