title: Cytomegalovirus in inflammatory bowel disease: A systematic review.
abstract: OBJECTIVE
  To identify definitions of cytomegalovirus (CMV) infection and intestinal disease, in inflammatory bowel disease (IBD), to determine the prevalence associated with these definitions.
  
  
  METHODS
  We conducted a systematic review and interrogated PubMed, EMBASE and Cochrane for literature on prevalence and diagnostics of CMV infection and intestinal disease in IBD patients. As medical headings we used "cytomegalovirus" OR "CMV" OR "cytomegalo virus" AND "inflammatory bowel disease" OR "IBD" OR "ulcerative colitis" OR "colitis ulcerosa" OR "Crohn's disease". Both MeSH-terms and free searches were performed. We included all types of English-language (clinical) trials concerning diagnostics and prevalence of CMV in IBD.
  
  
  RESULTS
  The search strategy identified 924 citations, and 52 articles were eligible for inclusion. We identified 21 different definitions for CMV infection, 8 definitions for CMV intestinal disease and 3 definitions for CMV reactivation. Prevalence numbers depend on used definition, studied population and region. The highest prevalence for CMV infection was found when using positive serum PCR as a definition, whereas for CMV intestinal disease this applies to the use of tissue PCR > 10 copies/mg tissue. Most patients with CMV infection and intestinal disease had steroid refractory disease and came from East Asia.
  
  
  CONCLUSIONS
  We detected multiple different definitions used for CMV infection and intestinal disease in IBD patients, which has an effect on prevalence numbers and eventually on outcome in different trials.
authors.affiliation: Tessa EH Römkens, Loes HC Nissen, Joost PH Drenth, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands.
authors.forename: Tessa E H
authors.initials: TE
authors.lastname: Römkens
authors.affiliation: Tessa EH Römkens, Loes HC Nissen, Joost PH Drenth, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands.
authors.forename: Geert J
authors.initials: GJ
authors.lastname: Bulte
authors.affiliation: Tessa EH Römkens, Loes HC Nissen, Joost PH Drenth, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands.
authors.forename: Loes H C
authors.initials: LH
authors.lastname: Nissen
authors.affiliation: Tessa EH Römkens, Loes HC Nissen, Joost PH Drenth, Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands.
authors.forename: Joost P H
authors.initials: JP
authors.lastname: Drenth
mesh_terms: D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D003587:Cytomegalovirus / Q000235:genetics / Q000472:pathogenicity*; D003586:Cytomegalovirus Infections / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D015995:Prevalence; D015203:Reproducibility of Results
chemical_list: D004279:DNA, Viral
keywords: Crohn’s disease; Cytomegalovirus; Inflammatory bowel disease; Systematic review; Ulcerative colitis
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