0
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Ulcerative Colitis and Cytomegalovirus Infection: From A to Z

      1 , 2 , 1 , 2 , 2

      Journal of Crohn's and Colitis

      Oxford University Press (OUP)

      Read this article at

      ScienceOpenPublisher
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Despite multiple studies, the role of cytomegalovirus [CMV] infection in exacerbating the severity of inflammation in ulcerative colitis [UC], and its response to treatment, remain debatable. Additionally, the optimal diagnostic tests for CMV infection in the setting of UC relapse, and timing of antiviral treatment initiation, remain unclear. The challenge faced by gastroenterologists is to differentiate between an acute UC flare and true CMV colitis. It seems that the presence of CMV colitis, as defined by the presence of intranuclear or intracellular inclusion bodies on haematoxylin and eosin [H&E] staining and/or positive immunohistochemistry [IHC] assay on histology, is associated with more severe colitis. Patients with CMV infection and acute severe colitis are more resistant to treatment with corticosteroids than non-infected patients. This refractoriness to steroids is related to colonic tissue CMV viral load and number of inclusion bodies [high-grade CMV infection] which may have a pronounced effect on clinical outcomes and colectomy rates. Whereas many studies showed no effect for antiviral treatment on colectomy rates in CMV-infected UC patients, there was a significant difference in colectomy rates of patients with high-grade infection who received anti-viral therapy compared with those who did not receive treatment. It was therefore proposed that high-grade CMV disease indicates that the virus is acting as a pathogen, whereas in those with low-grade CMV disease, the severity of IBD itself is more likely to influence outcome. The different algorithms that have been put forward for the management of patients with UC and concomitant CMV infection are discussed.

          Related collections

          Most cited references 90

          • Record: found
          • Abstract: not found
          • Article: not found

          Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: Definitions, Diagnosis, Extra-intestinal Manifestations, Pregnancy, Cancer Surveillance, Surgery, and Ileo-anal Pouch Disorders.

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Tofacitinib as Induction and Maintenance Therapy for Ulcerative Colitis

            Tofacitinib, an oral, small-molecule Janus kinase inhibitor, was shown to have potential efficacy as induction therapy for ulcerative colitis in a phase 2 trial. We further evaluated the efficacy of tofacitinib as induction and maintenance therapy.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Second European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease.

                Bookmark

                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                Journal of Crohn's and Colitis
                Oxford University Press (OUP)
                1873-9946
                1876-4479
                August 01 2020
                September 07 2020
                February 27 2020
                August 01 2020
                September 07 2020
                February 27 2020
                : 14
                : 8
                : 1162-1171
                Affiliations
                [1 ]Department of Internal Medicine, American University of Beirut Medical Centre, Beirut, Lebanon
                [2 ]Gastroenterology and Liver Services, Concord Hospital, Sydney, NSW, Australia
                Article
                10.1093/ecco-jcc/jjaa036
                © 2020

                Comments

                Comment on this article