CYTOMEGALOVIRUS INFECTION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Keywords:
Cytomegalovirus, CMV-associated colitis, Cytomegalovirus infection, inflammation, inflammatory bowel disease, ulcerative colitis, Crohn's disease, opportunistic inf ectionAbstract
Despite multiple studies, the effect of Cytomegalovirus (CMV) infection on the severity and worsening of inflammation, as well as the resistance to treatment in patients with Inflammatory bowel disease (IBD), is still a
topic for discussion. During the past years, there have been many discussions on the role of CMV for the worsening of IBD. Some authors acknowledge the active role of CMV for the worsening of IBD, while others encourage the concept of the "innocent" side observer, supporting the idea that the CMV infection does not play a role in disease progression. This review aimed to make a comprehensive analysis of the current aspects of accumulated CMV infection in IBD patients, including epidemiology, risk factors, clinical characteristics, diagnostic tests, the role of immunosuppressants and the indications for antiviral treatment.
References
Chang JT. Pathophysiology of Inflammatory Bowel Diseases. N Engl J Med, 2020, 383(27):2652–2664.
Khan S et al. Factors influencing the quality of life in inflammatory bowel disease: A comprehensive review. Dis Mon, 2024, 70(1):101672.
Piovani D, Danese S, Peyrin-Biroulet L, Bonovas S. Inflammatory bowel disease: estimates from the global burden of disease 2017 study. Aliment Pharmacol Ther, 2020, 51(2):261–270.
Turner D et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology, 2021, 160(5):1570–1583.
Mirchev M, Peruhova M, Boeva I, Stoitsov V. Inflammatory Bowel Disease – Current and Future Perspectives of the Biological Treatment. Bulg J Hepatogastroenterology, 2023, (1):1–8.
Toruner M et al. Risk Factors for Opportunistic Infections in Patients With Inflammatory Bowel Disease. Gastroenterology, 2008, 134(4):929–936.
Dioverti MV, Razonable RR. Cytomegalovirus. Microbiol Spectr, 2016, 4(4).
Zuhair M et al. Estimation of the worldwide seroprevalence of cytomegalovirus: A systematic review and meta-analysis. Rev Med Virol, 2019, 29(3):1–6.
Leruez-Ville M, Foulon I, Pass R, Ville Y. Cytomegalovirus infection during pregnancy: state of the science. Am J Obstet Gynecol, 2020, 223(3):330–349.
Rowshani AT, Bemelman FJ, van Leeuwen EMM et al. Clinical and Immunologic Aspects of Cytomegalovirus Infection in Solid Organ Transplant
Recipients. Transplantation, 2005, 79(4):381–386.
Serquiña AK, Ziegelbauer JM. How herpesviruses pass on their genomes. J Cell Biol, 2017, 216(9):2611–2613.
Griffiths P, Reeves M. Pathogenesis of human cytomegalovirus in the immunocompromised host. Nat Rev Microbiol, 2021, 19(12):759–773.
Siegmund B. Cytomegalovirus infection associated with inflammatory bowel disease. Lancet Gastroenterol Hepatol, 2017, 2(5):369–376.
Kandiel A, Lashner B. Cytomegalovirus colitis complicating inflammatory bowel disease. Am J Gastroenterol, 2006.
Powell RD, Warner NE, Levine RS, Kirsner JB. Cytomegalic inclusion disease and ulcerative colitis. Am J Med, 1961, 30(2):334–340.
Römkens TEH. Cytomegalovirus in inflammatory bowel disease: A systematic review. World J Gastroenterol, 2016, 22(3):1321.
Lv Y et al. Is cytomegalovirus infection related to inflammatory bowel disease, especially steroid-resistant inflammatory bowel disease? A meta-analysis. Infect Drug Resist, 2017, 10:511–519.
Garrido E. Clinical significance of cytomegalovirus infection in patients with inflammatory bowel disease. World J Gastroenterol, 2013,19(1):17.
Lopes S et al. Looking into Enteric Virome in Patients with IBD. Inflamm Bowel Dis, 2017, 23(8):1278–1284.
Roblin X et al. Prevalence of Cytomegalovirus Infection in Steroid-refractory Crohn’s Disease. Inflamm Bowel Dis, 2012, 18(7):E1396–E1397.
Al-Zafiri R, Gologan A, Galiatsatos P, Szilagyi A. Cytomegalovirus complicating inflammatory bowel disease: A 10-year experience in a community-based, university-affiliated hospital. Gastroenterol Hepatol, 2012, 8(4):230–239.
Kishore J et al. Infection with cytomegalovirus in patients with inflammatory bowel disease: prevalence, clinical significance and outcome. J Med Microbiol, 2004, 53(11):1155–1160.
Yadegarynia D et al. Prevalence of cytomegalovirus infection in patients with ulcerative colitis: A prospective cross-sectional study in Tehran, Iran. Iran J Microbiol, 2018, 10(5):342–347.
Kim JJ, Simpson N, Klipfel N et al. Cytomegalovirus Infection in Patients with Active Inflammatory Bowel Disease. Dig Dis Sci, 2010, 55(4):1059–1065.
Gauss A et al. Intestinal cytomegalovirus infection in patients hospitalized for exacerbation of inflammatory bowel disease. Eur J Gastroenterol Hepatol, 2015, 27(6):712–720.
McCurdy JD et al. A Model for Identifying Cytomegalovirus in Patients With Inflammatory Bowel Disease. Clin Gastroenterol Hepatol, 2015, 13(1):131–137.
Qin Y et al. Risk Factors of Cytomegalovirus Reactivation in Ulcerative Colitis Patients: A Meta-Analysis. Diagnostics, 2021, 11(11):1952.
Jentzer A et al. Cytomegalovirus and Inflammatory Bowel Diseases (IBD) with a Special Focus on the Link with Ulcerative Colitis (UC). Microorganisms, 2020, 8(7):1078.
Lee H-S et al. Risk Factors and Clinical Outcomes Associated with Cytomegalovirus Colitis in Patients with Acute Severe Ulcerative Colitis. Inflamm Bowel Dis, 2016, 22(4):912–918.
Kim YS et al. The Prevalence and Efficacy of Ganciclovir on Steroid-refractory Ulcerative Colitis With Cytomegalovirus Infection. J Clin Gastroenterol, 2012, 46(1):51–56.
Ford AC, Peyrin-Biroulet L. Opportunistic infections with anti-tumor necrosis factor-α therapy in inflammatory bowel disease: Meta-analysis of randomized controlled trials. Am J Gastroenterol, 2013, 108(8):1268–1276.
Sandborn WJ et al. Safety of Tofacitinib for Treatment of Ulcerative
Colitis, Based on 4.4 Years of Data From Global Clinical Trials. Clin Gastroenterol Hepatol, 2019, 17(8):1541–1550.
Rawa-Gołębiewska A, Lenarcik M, Zagórowicz E. Resolution of CMV Infection in the Bowel on Vedolizumab Therapy. J Crohn’s Colitis,
, 13(9):1234–1235.
Mourad FH, Hashash JG, Kariyawasam VC, Leong RW. Ulcerative Colitis and Cytomegalovirus Infection: From A to Z. J Crohn’s Colitis, 2020, 14(8):1162–1171.
Nguyen M, Bradford K, Zhang X, Shih DQ. Cytomegalovirus Reactivation in Ulcerative Colitis Patients. Ulcers, 2011, 2011:1–7.
Levin A, Yaari S, Stoff R et al. Diagnosis of Cytomegalovirus Infection during Exacerbation of Ulcerative Colitis. Digestion, 2017, 96(3):142–148.
Wu X, Wu L, Ji H, Wang F. Relationship Between Cytomegalovirus Infection and Steroid Resistance in Inflammatory Bowel Disease: A Meta-Analysis. Dig Dis Sci, 2015, 60(11):3203–3208.
Zhang C, Krishna SG, Hinton A et al. Cytomegalovirus-Related Hospitalization Is Associated With Adverse Outcomes and Increased
Health-Care Resource Utilization in Inflammatory Bowel Disease. Clin Transl Gastroenterol, 2016, 7(3):e150.
Yoon J et al. Endoscopic features and clinical outcomes of cytomegalovirus gastroenterocolitis in immunocompetent patients. Sci Rep, 2021, 11(1):6284.
Kucharzik T et al. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. J Crohn’s Colitis, 2021, 15(6):879–913.
Beswick L, Ye B, van Langenberg DR. Toward an Algorithm for the Diagnosis and Management of CMV in Patients with Colitis. Inflamm Bowel Dis, 2016, 22(12):2966–2976.
Lamb CA et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut, 2019, 68(Suppl 3):s1–s106.
Sager K, Alam S, Bond A et al. Review article: cytomegalovirus and inflammatory bowel disease. Aliment Pharmacol Ther, 2015, 41(8):725–733.
Jones A et al. Effects of Antiviral Therapy for Patients With Inflammatory
Bowel Disease and a Positive Intestinal Biopsy for Cytomegalovirus. Clin Gastroenterol Hepatol, 2015, 13(5):949–955.
Kopylov U. Antiviral therapy in cytomegalovirus-positive ulcerative colitis: A systematic review and meta-analysis. World J Gastroenterol, 2014, 20(10):2695.
Shukla T, Singh S, Loftus EV et al. Antiviral Therapy in Steroid-refractory Ulcerative Colitis with Cytomegalovirus. Inflamm Bowel Dis, 2015, 21(11):2718–2725.
Pillet S. Cytomegalovirus and ulcerative colitis: Place of antiviral therapy. World J Gastroenterol, 2016, 22(6):2030.
Meeralam Y et al. Cytomegalovirus Colitis in a Patient With Ulcerative Colitis on Vedolizumab Monotherapy. Cureus, 2023, 15(2):10–13.
Lawlor G, Moss AC. Cytomegalovirus in inflammatory bowel disease: Pathogen or innocent bystander? Inflamm Bowel Dis, 2010, 16(9):1620–1627.
Criscuoli V et al. Severe acute colitis associated with CMV: a prevalence study. Dig Liver Dis, 2004, 36(12):818–820.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 P. Peneva, H. Valkov, B. Vladimirov, P. Penchev (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
You are free to share, copy and redistribute the material in any medium or format under these terms.
