title: Antiviral Treatment for Colonic Cytomegalovirus Infection in Ulcerative Colitis Patients Significantly Improved Their Surgery Free Survival.
abstract: The frequency of cytomegalovirus (CMV) colitis in steroid-refractory inflammatory bowel disease has been reported to range from 15.8% to 34.0%. Infected patients are more likely to become hospitalized, have longer lengths of stay, and higher mortality rates. Current data are limited to small scale studies and showed conflicting result regarding the role of antiviral therapy.
  
  
  
  (1) To investigate the role of antiviral treatment in ulcerative colitis (UC) patients with CMV infection. (2) To investigate the role of viremia in the outcomes of these patients.
  
  
  
  The Cleveland Clinic pathology database identified 1478 patients who had colon biopsy and were tested for CMV during 1990 to 2013. After inclusion and exclusion, 41 UC patients were selected. Among them, 24 (58.5%) received treatment, 17 (41.5%) did not. A total of 14 demographic data and 4 clinical outcomes (surgery free survival, hospitalization, rehospitalization, and mortality) were compared between treated and nontreated patients. The same outcomes were also compared in patients who received treatment based on their viremia status.
  
  
  
  All demographic variables are similar between those treated and nontreated groups. Antiviral therapy significantly improved the surgery free survival within 30 days, and lasted 70 months (P<0.01). In contrast, hospitalization, rehospitalization, and mortality were comparable (P>0.05). No significant difference was observed in any of the clinical outcomes based on viremia status.
  
  
  
  Our small scale study demonstrates that antiviral treatment for colonic CMV infection significantly improves the surgery free survival short-term and long-term in patients with UC.
authors.affiliation: Victor W Fazio, MD Center for Inflammatory Bowel Disease.
authors.forename: Yinghong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: School of Medicine, St Georges University, Grenada, West Indies.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Aggarwal
authors.affiliation: Department of Pathology, Cleveland Clinic, Cleveland, OH.
authors.forename: Xiuli
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Pathology, Cleveland Clinic, Cleveland, OH.
authors.forename: Haiyan
authors.initials: H
authors.lastname: Lu
authors.affiliation: Colorectal Department, Digestive Disease Institute, The Cleveland Clinic Foundation.
authors.forename: Lei
authors.initials: L
authors.lastname: Lian
authors.affiliation: Colorectal Department, Digestive Disease Institute, The Cleveland Clinic Foundation.
authors.forename: Xianrui
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Gastroenterology, Dalian Medical University, Dalian, P.R. China.
authors.forename: Shibin
authors.initials: S
authors.lastname: Guo
authors.affiliation: Victor W Fazio, MD Center for Inflammatory Bowel Disease.
authors.forename: Nitin
authors.initials: N
authors.lastname: Aggarwal
authors.affiliation: Victor W Fazio, MD Center for Inflammatory Bowel Disease.
authors.forename: Bret
authors.initials: B
authors.lastname: Lashner
authors.affiliation: Victor W Fazio, MD Center for Inflammatory Bowel Disease.
authors.forename: Bo
authors.initials: B
authors.lastname: Shen
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D003082:Colectomy / Q000706:statistics & numerical data; D003093:Colitis, Ulcerative / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D003586:Cytomegalovirus Infections / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents