Intestinal Research

Original Articles

Diagnostic performance of noninvasive tests for cytomegalovirus ileocolitis: a systematic review and meta-analysis: Thanaboon Chaemsupaphan, Onuma Sattayalertyanyong, Julajak Limsrivilai; Received August 27, 2024 Accepted October 8, 2024 Published online January 14, 2025; DOI: https://doi.org/10.5217/ir.2024.00136 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Diagnosis of cytomegalovirus (CMV) ileocolitis traditionally requires colonoscopy with tissue biopsy. Due to potential complications in high-risk patients, there is growing interest in serum and stool tests for diagnosing this condition. We aimed to evaluate the diagnostic accuracy of these noninvasive tests compared to traditional gold standards.
Methods
Two independent reviewers performed a comprehensive search on MEDLINE and Embase from inception up to October 1, 2023. Prospective and retrospective studies evaluating the performance of serum CMV polymerase chain reaction (PCR), serum CMV antigen (Ag), and stool CMV PCR in diagnosing CMV ileocolitis were included. Tissue histopathology or tissue CMV PCR served as reference standards. Diagnostic performances of each serum and stool test were calculated based on a meta-analysis using random-effects model.
Results
A total of 30 studies, comprising 23 studies of serum CMV PCR, 9 of serum CMV Ag, and 7 of stool CMV PCR, were included. The pooled sensitivity, specificity, and area under summary receiver operating characteristic curves were 62% (95% confidence interval [CI], 51%–72%), 90% (95% CI, 79%–96%), and 0.81 for serum CMV PCR, 38% (95% CI, 26%–51%), 94% (95% CI, 70%–99%), and 0.56 for serum CMV Ag, and 53% (95% CI, 35%–70%), 91% (95% CI, 84%–95%), and 0.84 for stool CMV PCR.
Conclusions
Serum and stool tests cannot replace colonoscopy for diagnosing CMV ileocolitis due to their low sensitivities but may be useful when colonoscopy is not feasible. Positive results can aid diagnosis, given their high specificities. Serum and/or stool CMV PCR are preferred over CMV Ag.

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IBD

Infectious complications in patients with inflammatory bowel disease in Asia: the results of a multinational web-based survey in the 8th Asian Organization for Crohn’s and Colitis meeting: Yu Kyung Jun, Seong-Joon Koh, Dae Seong Myung, Sang Hyoung Park, Choon Jin Ooi, Ajit Sood, Jong Pil Im; Intest Res 2023;21(3):353-362. Published online July 27, 2023; DOI: https://doi.org/10.5217/ir.2023.00013

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Infectious complications are major concerns when treating patients with inflammatory bowel disease (IBD). This study evaluated clinical differences across countries/regions in the management of infectious diseases in patients with IBD.
Methods
A multinational online questionnaire survey was administered to participants at the 8th meeting of the Asian Organization for Crohn’s and Colitis. The questionnaire included questions regarding surveillance, diagnosis, management, and prevention of infection in patients with IBD.
Results
A total of 384 physicians responded to the questionnaire. The majority of Korean (n=70, 63.6%) and Chinese (n=51, 51.5%) physicians preferred vancomycin to metronidazole in the treatment of Clostridium difficile infection, whereas more than half of the Japanese physicians (n=62, 66.7%) preferred metronidazole. Physicians in Korea (n=88, 80.0%) and China (n=46, 46.5%) preferred a 3-month course of isoniazid and rifampin to treat latent tuberculosis infection, whereas most physicians in Japan (n=71, 76.3%) favored a 9-month course of isoniazid. Most Korean physicians (n=89, 80.9%) recommended hepatitis B virus (HBV) vaccination in patients lacking HBV surface antigen, whereas more than half of Japanese physicians (n=53, 57.0%) did not consider vaccination.
Conclusions
Differences in the diagnosis, prevention, and management of infections in patients with IBD across countries/regions reflect different prevalence rates of infectious diseases. This survey may broaden understanding of the real-world clinical settings across Asian countries/regions and provide information for establishing practical guidelines to manage patients with IBD.

Citations

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Characteristics and outcomes of portal vein thrombosis in patients with inflammatory bowel disease in Korea
Ki Jin Kim, Su-Bin Song, Jung-Bin Park, June Hwa Bae, Ji Eun Baek, Ga Hee Kim, Min-Jun Kim, Seung Wook Hong, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Yong-Sik Yoon, Jong-Lyul Lee, Min Hy
The Korean Journal of Internal Medicine.2025; 40(2): 243. CrossRef
The Burden ofClostridioides difficileInfection in Korea
Seong Ran Jeon
Journal of Korean Medical Science.2024;[Epub] CrossRef
Perception of fecal microbiota transplantation in patients with ulcerative colitis in Korea: a KASID multicenter study
Jebyung Park, Sung Noh Hong, Hong Sub Lee, Jongbeom Shin, Eun Hye Oh, Kwangwoo Nam, Gyeol Seong, Hyun Gun Kim, Jin-Oh Kim, Seong Ran Jeon
The Korean Journal of Internal Medicine.2024; 39(5): 783. CrossRef
Assessing the associations of inflammatory bowel disease and hepatitis B virus infections with two-sample bidirectional mendelian randomization
Ping Han, Chaohui Wang, Yan Qiu
Critical Public Health.2024; 34(1): 1. CrossRef
Diagnosis, management, and prevention of infectious complications in inflammatory bowel disease: variations among Asian countries
Ji Eun Baek, Sung Wook Hwang
Intestinal Research.2023; 21(3): 277. CrossRef

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Inflammatory Bowel Diseases

High mucosal cytomegalovirus DNA helps predict adverse short-term outcome in acute severe ulcerative colitis: Saransh Jain, Divya Namdeo, Pabitra Sahu, Saurabh Kedia, Peush Sahni, Prasenjit Das, Raju Sharma, Vipin Gupta, Govind Makharia, Lalit Dar, Simon PL Travis, Vineet Ahuja; Intest Res 2021;19(4):438-447. Published online November 6, 2020; DOI: https://doi.org/10.5217/ir.2020.00055

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Predictors of short-term outcome of intravenous (IV) steroid therapy in acute severe ulcerative colitis (ASUC) have been well described, but the impact of cytomegalovirus (CMV) infection as a predictor of outcome remains debatable. We investigated the role of quantitative CMV polymerase chain reaction (PCR) as a predictor of short-term outcome in patients with ASUC.
Methods
Consecutive patients with ASUC satisfying Truelove and Witts criteria hospitalized at All India Institute of Medical Sciences (AIIMS) from May 2016 to July 2019 were included; all received IV steroid. The primary outcome measure was steroid-failure defined as the need for rescue therapy (with ciclosporin or infliximab) or colectomy during admission. AIIMS’ index (ulcerative colitis index of severity > 6 at day 1+fecal calprotectin > 1,000 μg/g at day 3), with quantitative CMV PCR on biopsy samples obtained at initial sigmoidoscopy were correlated with the primary outcome.
Results
Thirty of 76 patients (39%) failed IV corticosteroids and 12 (16%) underwent surgery. Patients with steroid failure had a significantly higher mucosal CMV DNA than responders (3,454 copies/mg [0–2,700,000] vs. 116 copies/mg [0–27,220]; P< 0.01). On multivariable analysis, mucosal CMV DNA load > 2,000 copies/mg (odds ratio [OR], 10.2; 95% confidence interval [CI], 2.6–39.7; P< 0.01) and AIIMS’ index (OR, 39.8; 95% CI, 4.4–364.4; P< 0.01) were independent predictors of steroid-failure and need for colectomy. The combination correctly predicted outcomes in 84% of patients with ASUC.
Conclusions
High mucosal CMV DNA ( > 2,000 copies/mg) independently predicts failure of IV corticosteroids and short-term risk of colectomy and it has an additional value to the established markers of disease severity in patients with ASUC.

Citations

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Systematic Review: Outcome Prediction in Acute Severe Ulcerative Colitis
Julia Angkeow, Alissa Rothman, Lara Chaaban, Nicole Paul, Joanna Melia
Gastro Hep Advances.2024; 3(2): 260. CrossRef
Predictors of adverse outcomes of steroids in patients with severe ulcerative colitis (systematic review and meta-analyses)
A. F. Mingazov, O. I. Sushkov, B. R. Kalanov, T. A. Baranova, S. I. Achkasov
Koloproktologia.2024; 23(1): 172. CrossRef
Predicting Outcome after Acute Severe Ulcerative Colitis: A Contemporary Review and Areas for Future Research
Sudheer Kumar Vuyyuru, Olga Maria Nardone, Vipul Jairath
Journal of Clinical Medicine.2024; 13(15): 4509. CrossRef
Low prevalence of Clostridioides difficile infection in acute severe ulcerative colitis: A retrospective cohort study from northern India
Sandeep Mundhra, David Thomas, Saransh Jain, Pabitra Sahu, Sudheer Vuyyuru, Peeyush Kumar, Bhaskar Kante, Rajesh Panwar, Peush Sahni, Rama Chaudhry, Prasenjit Das, Govind Makharia, Saurabh Kedia, Vineet Ahuja
Indian Journal of Gastroenterology.2023; 42(3): 411. CrossRef
The role of cytomegalovirus colitis on short- and long-term outcomes for patients with ulcerative colitis
Mengmeng Zhang, Xiaoyin Bai, Huimin Zhang, Yan You, Hong Lv, Yue Li, Bei Tan, Ji Li, Hui Xu, Weiyang Zheng, Hong Yang, Jiaming Qian
Scandinavian Journal of Gastroenterology.2022; 57(3): 282. CrossRef
Cytomegalovirus in ulcerative colitis: an evidence-based approach to diagnosis and treatment
Anuraag Jena, Shubhra Mishra, Anupam Kumar Singh, Aravind Sekar, Vishal Sharma
Expert Review of Gastroenterology & Hepatology.2022; 16(2): 109. CrossRef
Prospective validation of AIIMS index as a predictor of steroid failure in patients with acute severe ulcerative colitis
Pabitra Sahu, Saransh Jain, Saurabh Kedia, Sudheer K. Vuyyuru, Peush Sahni, Raju Sharma, Rajesh Panwar, Prasenjit Das, Vipin Gupta, Govind Makharia, Simon Travis, Vineet Ahuja
Indian Journal of Gastroenterology.2022; 41(3): 273. CrossRef
Cytomegalovirus Infection in Patients with Inflammatory Bowel Disease
Jun Lee
The Korean Journal of Gastroenterology.2022; 80(2): 60. CrossRef
The Impact of Human Herpesviruses in Clinical Practice of Inflammatory Bowel Disease in the Era of COVID-19
Shuhei Hosomi, Yu Nishida, Yasuhiro Fujiwara
Microorganisms.2021; 9(9): 1870. CrossRef
Does cytomegalovirus load predict the outcome of acute severe ulcerative colitis?
You Sun Kim
Intestinal Research.2021; 19(4): 357. CrossRef

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IBD

Distribution of cytomegalovirus genotypes among ulcerative colitis patients in Okinawa, Japan: Saifun Nahar, Akira Hokama, Atsushi Iraha, Tetsuya Ohira, Tetsu Kinjo, Tetsuo Hirata, Takeshi Kinjo, Gretchen L. Parrott, Jiro Fujita; Intest Res 2018;16(1):90-98. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.90

Abstract PDF PubReader ePub

Background/Aims

To determine the prevalence of glycoprotein B (gB), glycoprotein N (gN), and glycoprotein H (gH) genotypes of human cytomegalovirus (HCMV) superimposed on ulcerative colitis (UC) patients in Japan.

Methods

Four archived stool samples and 7-archived extracted DNA from stool samples of 11 UC patients with positive multiplex polymerase chain reaction (PCR) results for HCMV were used UL55 gene encoding gB, UL73 gene encoding gN, and UL75 gene encoding gH were identified by PCR. Genotypes of gB and glycoprotein N were determined by sequencing.

Results

Among 11 samples, 8 samples were amplified through PCR. gB, gN, and gH genotypes were successfully detected in 3 of 8 (37.5%), 4 of 8 (50%), and 8 of 8 (100%), respectively. The distribution of gB and gN genotypes analyzed through phylogenetic analysis were as follows: gB1 (2/3, 66.7%), gB3 (1/3, 33.3%), gN3a (2/4, 50%), and gN3b (2/4, 50%). Other gB genotypes (gB2 and gB4) and gN genotypes (gN1, gN2, and gN4) were not detected in this study. Out of successfully amplified 8 samples of gH genotype, gH1 and gH2 were distributed in 12.5% and 75% samples, respectively. Only 1 sample revealed mixed infection of gH genotype. The distribution of gH1 and gH2 differed significantly (1:6, P<0.05) in UC patients. The distribution of single gH genotype also revealed significant difference in UC patients who were treated with immunosuppressive drug (P<0.05).

Conclusions

In this study, gB1, gN3, and gH2 gene were determined as the most frequently observed genotypes in UC patients, which suggest that there might be an association between these genotypes of HCMV and UC.

Citations

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Tamara Vasiljevic, Marko Jankovic, Ana Tomic, Ida Bakrac, Stefan Radenovic, Danijela Miljanovic, Aleksandra Knezevic, Tanja Jovanovic, Irena Djunic, Milena Todorovic-Balint
Pharmaceuticals.2024; 17(4): 428. CrossRef
Cytomegalovirus Genotype Distribution among Congenital and Perinatal Infected Patients with CMV-Associated Thrombocytopenia
Hongbo Hu, Wenwen Peng, Qiaoying Peng, Ying Cheng
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Cytomegalovirus Genotype and Virulence in Infants with Congenital Infection
Hong-bo Hu, Jian-gang Wu, Jian-jun Sun, Qiao-ying Peng, Xiao-peng Shang
Journal of Pediatric Infectious Diseases.2021; 16(04): 171. CrossRef
Common Polymorphisms in the Glycoproteins of Human Cytomegalovirus and Associated Strain-Specific Immunity
Hsuan-Yuan Wang, Sarah M. Valencia, Susanne P. Pfeifer, Jeffrey D. Jensen, Timothy F. Kowalik, Sallie R. Permar
Viruses.2021; 13(6): 1106. CrossRef
Cytomegalovirus and Inflammatory Bowel Diseases (IBD) with a Special Focus on the Link with Ulcerative Colitis (UC)
Alexandre Jentzer, Pauline Veyrard, Xavier Roblin, Pierre Saint-Sardos, Nicolas Rochereau, Stéphane Paul, Thomas Bourlet, Bruno Pozzetto, Sylvie Pillet
Microorganisms.2020; 8(7): 1078. CrossRef

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Case Report

Pulmonary embolism in an immunocompetent patient with acute cytomegalovirus colitis: Jen-Wei Chou, Ken-Sheng Cheng; Intest Res 2016;14(2):187-190. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.187

Abstract PDF PubReader ePub

Acute cytomegalovirus (CMV) infection occurs commonly in immunocompromised and immunocompetent patients, but is usually asymptomatic in the latter. Vascular events associated with acute CMV infection have been described, but are rare. Hence, such events are rarely reported in the literature. We report a case of pulmonary embolism secondary to acute CMV colitis in an immunocompetent 78-year-old man. The patient presented with fever and diarrhea. Colonic ulcers were diagnosed based on colonoscopy findings, and CMV was the proven etiology on pathological examination. The patient subsequently experienced acute respiratory failure. Pulmonary embolism was diagnosed based on the chest radiography and computed tomography findings. A diagnosis of acute CMV colitis complicated by pulmonary embolism was made. The patient was successfully treated with intravenous administration of unfractionated heparin and intravenous ganciclovir.

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Venous thromboembolism in infectious diseases
Priyanka P. Nigade, Sagar S. Dhanagar, Vandana S. Nikam
Comparative Clinical Pathology.2025;[Epub] CrossRef
Cytomegalovirus-Induced Pericarditis, Pulmonary Embolism, and Transaminitis in an Immunocompetent Patient
Waiz Wasey, Navpreet Badesha, Maria Rossi, Caitlin Carter, Samantha Bibee
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Risk factors of venous thrombo-embolism during cytomegalovirus infection in immunocompetent individuals. A systematic review
Manuela Ceccarelli, Emmanuele Venanzi Rullo, Giuseppe Nunnari
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Venous thromboembolism related to cytomegalovirus infection
Amar H. Kelkar, Kavitha S. Jacob, Eman B. Yousif, John J. Farrell
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Original Article

Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis: Jaeyoung Chun, Changhyun Lee, Ji-eun Kwon, Sung Wook Hwang, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, Jong Pil Im; Intest Res 2015;13(1):50-59. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.50

Abstract PDF PubReader

Background/Aims

Patients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC.

Methods

We retrospectively reviewed the medical records of patients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as ≥1 pp65-positive cell per 2×10⁵ polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive immunohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration.

Results

A total of 43 patients were enrolled. CMV antigenemia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P =0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P =0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P =0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P =0.025).

Conclusions

The CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia.

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The association between antigenemia, histology with immunohistochemistry, and mucosal PCR in the diagnosis of ulcerative colitis with concomitant human cytomegalovirus infection
Tsukasa Yamawaka, Hiroki Kitamoto, Masanori Nojima, Tomoe Kazama, Kohei Wagatsuma, Keisuke Ishigami, Shuji Yamamoto, Yusuke Honzawa, Minoru Matsuura, Hiroshi Seno, Hiroshi Nakase
Journal of Gastroenterology.2023; 58(1): 44. CrossRef
Predictive Factors of Cytomegalovirus Viremia during the Clinical Course of Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: A Single Center Observational Study
Makoto Harada, Ryohei Iwabuchi, Akinori Yamaguchi, Daiki Aomura, Yosuke Yamada, Kosuke Sonoda, Yutaka Kamimura, Koji Hashimoto, Yuji Kamijo
Journal of Clinical Medicine.2023; 12(1): 351. CrossRef
A quick guide to diagnosis and treatment of cytomegalovirus infection in the gut: current dilemmas
Iļja Drjagunovs, Sniedze Laivacuma, Indra Zeltiņa, Aleksejs Derovs
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Hamideh Molaei, Leila Khedmat, Eghlim Nemati, Zohreh Rostami, Seyed Hassan Saadat
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Granulocyte and Monocyte Adsorptive Apheresis for Ulcerative Colitis in a Patient with Low Bone Mineral Density Due to Fanconi-Bickel Syndrome
Makoto Tanaka, Mayuko Nakanishi, Hajime Miyazaki, Ryuichi Morita, Hiroki Eguchi, Yoshiya Takeda, Masanobu Katayama, Motoo Tanaka, Masamichi Bamba, Tadashi Shigematsu
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Naoki Shijubou, Toshiyuki Sumi, Koki Kamada, Takeyuki Sawai, Yuichi Yamada, Tatsuru Ikeda, Hisashi Nakata, Yuji Mori, Hirofumi Chiba
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Yafei Qin, Grace Wang, Dejun Kong, Guangming Li, Hongda Wang, Hong Qin, Hao Wang
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High mucosal cytomegalovirus DNA helps predict adverse short-term outcome in acute severe ulcerative colitis
Saransh Jain, Divya Namdeo, Pabitra Sahu, Saurabh Kedia, Peush Sahni, Prasenjit Das, Raju Sharma, Vipin Gupta, Govind Makharia, Lalit Dar, Simon PL Travis, Vineet Ahuja
Intestinal Research.2021; 19(4): 438. CrossRef
Current Diagnostic and Therapeutic Approaches to Cytomegalovirus Infections in Ulcerative Colitis Patients Based on Clinical and Basic Research Data
Yoshihiro Yokoyama, Tsukasa Yamakawa, Takehiro Hirano, Tomoe Kazama, Daisuke Hirayama, Kohei Wagatsuma, Hiroshi Nakase
International Journal of Molecular Sciences.2020; 21(7): 2438. CrossRef
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Fadi H Mourad, Jana G Hashash, Viraj C Kariyawasam, Rupert W Leong
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Alexandre Jentzer, Pauline Veyrard, Xavier Roblin, Pierre Saint-Sardos, Nicolas Rochereau, Stéphane Paul, Thomas Bourlet, Bruno Pozzetto, Sylvie Pillet
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Ali Y. Fakhreddine, Catherine T. Frenette, Gauree G. Konijeti
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Kiyotaka Okawa, Tetsuya Aoki, Wataru Ueda, Koji Sano, Hiroshi Ono, Syusuke Nakauchi
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Sung Chul Park, Yoon Mi Jeen, Yoon Tae Jeen
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Risk Factors and Clinical Outcomes Associated with Cytomegalovirus Colitis in Patients with Acute Severe Ulcerative Colitis
Ho-Su Lee, Sang Hyoung Park, Sung-Han Kim, Jihun Kim, Jene Choi, Hyo Jeong Lee, Wan Soo Kim, Jeong-Mi Lee, Min Seob Kwak, Sung Wook Hwang, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Ki
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Author's Reply
Jaeyoung Chun, Jong Pil Im
Intestinal Research.2015; 13(2): 184. CrossRef
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Saifun Nahar
World Journal of Gastroenterology.2015; 21(44): 12667. CrossRef

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Review

Diagnosis and Treatment of Ulcerative Colitis with Cytomegalovirus Infection: Importance of Controlling Mucosal Inflammation to Prevent Cytomegalovirus Reactivation: Hiroshi Nakase, Yusuke Honzawa, Takahiko Toyonaga, Satoshi Yamada, Naoki Minami, Takuya Yoshino, Minoru Matsuura; Intest Res 2014;12(1):5-11. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.5

Abstract PDF PubReader

Human cytomegalovirus (HCMV) is a member of the herpesvirus family. HCMV infection persists throughout the host lifespan in a latent state following primary infection. The ability of HCMV to escape control by the host immune system and its resulting reactivation suggests the importance of ongoing immune surveillance in the prevention of HCMV reactivation. HCMV is a common cause of opportunistic infection that causes severe and fatal disease in immune-compromised individuals. In inflammatory bowel disease patients, particularly those with ulcerative colitis (UC), HCMV is often reactivated because these patients are frequently treated with immunosuppressive agents. This reactivation exacerbates colitis. Additionally, HCMV infection can induce severe colitis, even in patients with UC who have never been treated with immunosuppressive agents. However, the role of HCMV in colonic inflammation in patients with UC remains unclear. Here, we present previous and current clinical data on the diagnosis and treatment of HCMV infection in UC. Additionally, our experimental data from a newly established mouse model mimicking UC with concomitant CMV infection clearly demonstrate that inflammation could result in the exacerbation of UC disease activity with induction of HCMV reactivation. In summary, optimal control of colonic inflammation should be achieved in UC patients who are refractory to conventional immunosuppressive therapies and are positive for HCMV.

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Alexandre Jentzer, Aymeric Cantais, Xavier Roblin, Mathilde Barrau, Arnauld Garcin, Thomas Bourlet, Bruno Pozzetto, Sylvie Pillet
Viruses.2025; 17(4): 555. CrossRef
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Dazhong Huang, Michael Rennie, Alicia Krasovec, Shyam Nagubandi, Sichang Liu, Edward Ge, Barinder Khehra, Michael Au, Shobini Sivagnanam, Vu Kwan, Claudia Rogge, Nikola Mitrev, Viraj Kariyawasam
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Danusia Onisor, Olga Brusnic, Simona Mocan, Mircea Stoian, Calin Avram, Adrian Boicean, Daniela Dobru
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The association between antigenemia, histology with immunohistochemistry, and mucosal PCR in the diagnosis of ulcerative colitis with concomitant human cytomegalovirus infection
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Author's Reply
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