title: Active cytomegalovirus infection diagnosed by real-time PCR in patients with inflammatory bowel disease: a prospective, controlled observational study (.).
abstract: OBJECTIVE
  It is assumed that cytomegaloviral (CMV) infection in inflammatory bowel disease (IBD) is caused by reactivation due to the immunosuppressive therapy, but the role of CMV as a pathophysiological factor and prognostic marker in IBD is unclear. The aim of this study was to investigate CMV infection in IBD, with real-time polymerase chain reaction (PCR) and immunohistochemistry, with emphasis on newly diagnosed disease.
  
  
  METHODS
  In this prospective, controlled study, 67 patients with IBD and 34 control patients with irritable bowel syndrome (IBS) or rectal bleeding were included. Serology for CMV was analysed along with CMV DNA in plasma, mucosal biopsies, and faeces. Mucosal biopsies were further analysed with histopathology and CMV immunohistochemistry.
  
  
  RESULTS
  Detection of CMV IgM was more common in patients with IBD, compared to controls, 21% versus 3%. CMV DNA was found in 16% of patients with newly diagnosed, untreated IBD and in 38% of steroid-treated patients. Four of the five patients that needed urgent surgery were CMV-DNA positive in at least one of three sample types. None of the controls had detectable CMV DNA.
  
  
  CONCLUSIONS
  Active CMV infection was found in high proportions of newly diagnosed untreated patients with IBD, in patients on immunosuppression and in patients in the need of surgery. Low CMV-DNA levels in non-immunosuppressed patients were not a risk factor for the development of more severe IBD, while the detection of CMV DNA in patients on immunosuppressive therapy may foresee disease progression.
authors.affiliation: a Department of Medical Sciences, Section of Gastroenterology and Hepatology , Uppsala University , Uppsala , Sweden ;
authors.forename: Mari
authors.initials: M
authors.lastname: Thörn
authors.affiliation: a Department of Medical Sciences, Section of Gastroenterology and Hepatology , Uppsala University , Uppsala , Sweden ;
authors.forename: Fredrik
authors.initials: F
authors.lastname: Rorsman
authors.affiliation: a Department of Medical Sciences, Section of Gastroenterology and Hepatology , Uppsala University , Uppsala , Sweden ;
authors.forename: Anders
authors.initials: A
authors.lastname: Rönnblom
authors.affiliation: a Department of Medical Sciences, Section of Gastroenterology and Hepatology , Uppsala University , Uppsala , Sweden ;
authors.forename: Per
authors.initials: P
authors.lastname: Sangfelt
authors.affiliation: b Department of Immunology, Genetics and Pathology , Uppsala University , Uppsala , Sweden ;
authors.forename: Alkwin
authors.initials: A
authors.lastname: Wanders
authors.affiliation: c Department of Medical Sciences, Section of Infectious Diseases , Uppsala University , Uppsala , Sweden ;
authors.forename: Britt-Marie
authors.initials: BM
authors.lastname: Eriksson
authors.affiliation: d Department of Medical Sciences, Clinical Microbiology and Infectious Medicine , Uppsala University , Uppsala , Sweden.
authors.forename: Kåre
authors.initials: K
authors.lastname: Bondeson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D004279:DNA, Viral / Q000032:analysis*; D005243:Feces / Q000821:virology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D012720:Severity of Illness Index; D013548:Sweden; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: CMV; Crohn’s disease; Cytomegalovirus; immunohistochemistry; inflammatory bowel disease; real-time PCR; ulcerative colitis;