Epstein-Barr virus viral load in Crohn's disease: effect of immunosuppressive therapy.
BACKGROUND
More than 80% of non-Hodgkin lymphomas (NHLs) occurring in transplant recipients on immunosuppressive therapy are associated with Epstein-Barr virus (EBV) infection. EBV viral load (EBV-VL) is predictive of NHL occurrence in this setting. The aim of this work was to determine EBV-VL in patients with Crohn's disease (CD), both according to disease activity and use of immunosuppressive therapy, including infliximab.


METHODS
Between December 1999 and July 2001, EBV-VL was determined 212 times by quantitative polymerase chain reaction (PCR) assay in 138 patients with CD and in 24 EBV-seropositive controls free of CD.


RESULTS
EBV-VL did not differ significantly between the controls and the patients with CD and was not influenced by CD activity or by immunosuppressive therapy, including recent infliximab infusion. High EBV-VL values were observed in two patients with severe uncontrolled CD, but returned to normal once the flare-up had been controlled (by immunosuppressive drugs in one case and by surgery in the other case).


CONCLUSIONS
EBV viral load is on the whole similar in patients with Crohn's disease and in EBV-seropositive controls. Infliximab infusion does not seem to increase significantly EBV-VL in the short-term. However, some patients with Crohn's disease have transient, very high EBV-VL values that are compatible with an increased risk of NHL in the transplant setting. The long-term clinical outcome of these patients must be determined.
Reijasse
Didier
D
Department of Gastroenterology, Saint-Antoine University, Paris, France.
Le Pendeven
Catherine
C
Cosnes
Jacques
J
Dehee
Axelle
A
Gendre
Jean-Pierre
JP
Nicolas
Jean-Claude
JC
Beaugerie
Laurent
L
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000175:diagnosis* / Q000453:epidemiology; D016022:Case-Control Studies; D003424:Crohn Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015994:Incidence; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D017678:Sex Distribution; D019562:Viral Load
D000911:Antibodies, Monoclonal; D004279:DNA, Viral; D007166:Immunosuppressive Agents; D000069285:Infliximab