Long-Term Outcomes of Cytomegalovirus Reactivation in Patients with Moderate to Severe Ulcerative Colitis: A Multicenter Study
- Authors
- Kim, You Sun; Kim, Young-Ho; Kim, Joo Sung; Jeong, Seong Yeon; Park, Soo Jeong; Cheon, Jae Hee; 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
- Issue Date
- Nov-2014
- Publisher
- EDITORIAL OFFICE GUT & LIVER
- Keywords
- Colitis; ulcerative; Cytomegalovirus; Ganciclovir; Colectomy
- Citation
- GUT AND LIVER, v.8, no.6, pp 643 - 647
- Pages
- 5
- Journal Title
- GUT AND LIVER
- Volume
- 8
- Number
- 6
- Start Page
- 643
- End Page
- 647
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/11653
- DOI
- 10.5009/gnl13427
- ISSN
- 1976-2283
2005-1212
- 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 long-term 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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