title: Cytomegalovirus disease in inflammatory bowel disease: epidemiology and disease characteristics in a large single-centre experience.
abstract: BACKGROUND
  Patients with inflammatory bowel disease (IBD) show an increased risk of developing cytomegalovirus (CMV) disease because of immunosuppressive medication and malnutrition. Here, we aimed to investigate the prevalence and clinical characteristics of CMV disease in our cohort of IBD patients.
  
  
  METHODS
  We carried out a retrospective analysis of 1023 IBD patients treated at our IBD clinic at the University Hospital Zurich between 2007 and 2014. CMV disease was defined as a positive immunohistochemistry for CMV and 14 patients were identified.
  
  
  RESULTS
  The prevalence of CMV disease in our IBD cohort was 1.37%. Twelve patients had ulcerative colitis and two had Crohn's disease with colonic involvement. All patients who developed CMV disease received immunosuppressive medication or, as in one case, had HIV infection. The most used immunosuppressive medications were steroids and azathioprine. The most common therapeutic strategy was the consecutive use of ganciclovir and valganciclovir. Ten patients recovered and two were treatment refractory; among these, one required colectomy and two had a relapse.
  
  
  CONCLUSIONS
  CMV disease may influence the clinical course of IBD. There is probably an association between CMV disease and IBD-specific medication. Risk factors, epidemiology and therapeutic strategy need to be further investigated.
authors.affiliation: aDivision of Gastroenterology and Hepatology, University Hospital Zurich bZurich Center for Integrative Human Physiology, University of Zurich cDivision of Gastroenterology and Hepatology, Triemli Hospital dDivision of Gastroenterology and Hepatology, Clinic Bethanien, Zurich eDivision of Gastroenterology and Hepatology, Kantonsspital St Gallen, Switzerland.
authors.forename: Jonas
authors.initials: J
authors.lastname: Bontà
authors.forename: Jonas
authors.initials: J
authors.lastname: Zeitz
authors.forename: Pascal
authors.initials: P
authors.lastname: Frei
authors.forename: Luc
authors.initials: L
authors.lastname: Biedermann
authors.forename: Michael C
authors.initials: MC
authors.lastname: Sulz
authors.forename: Stephan R
authors.initials: SR
authors.lastname: Vavricka
authors.forename: Sylvie
authors.initials: S
authors.lastname: Scharl
authors.forename: Michael
authors.initials: M
authors.lastname: Fried
authors.forename: Gerhard
authors.initials: G
authors.lastname: Rogler
authors.forename: Michael
authors.initials: M
authors.lastname: Scharl
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D008297:Male; D009894:Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents