The Relationship Between Cytomegalovirus And Recurrent Inflammatory Bowel Disease And Predict The Efficacy Of Antiviral Therapy

Aim1. Investigate the relationship between recurrent Inflammatory Bowel Disease and Cytomegalovirus infection who were diagnosed by immunohistochemistry.2. Search for the possible index to predict the efficacy of antiviral therapy.MethodReview the electronic medical record of Inflammatory Bowel Disease patients who hospitalized in Sir Run Run Shaw Hospital digestive department from2011.3to2014.4. Internalize the patients who had done the test of Cytomegalovirus immunohistochemistry and the patients who had other evidence of Cytomegalovirus infection. The patients were grouped into immunohistochemistry positive and negative groups by the result of Cytomegalovirus immunohistochemistry, and antiviral therapy effective and inefficient groups by the efficacy of antiviral therapy. Record the general state, disease activity, lab test, and clinical result of the patients. ResultReview the electronic medical record of Sir Run Run Shaw Hospital digestive department from2011.3to2014.4, there were28patients who had done the test of Cytomegalovirus immunohistochemistry of colon tissue and21patients who had evidence of Cytomegalovirus infection.10of the28patients were Cytomegalovirus immunohistochemistry positive, and the other18were negative. Compared to the18patients, the10patients had higher ratio of the using of steroid or immunosuppressant or infliximab(60%vs16.67%, p=0.035), higher disease activity score (SAI:211.00±32.00vs190.00±21.00, p=0.027; CDAI:272.00±76.00vs152.00±162.00, p=0.067), lower albumin and heamoglobin level (albumin:3.06±0.95vs3.60±0.70g/dL, p=0.027; heamoglobin:9.60±2.50vs11.85±3.38g/dL, p=0.032), more patients need steroid (90.00%vs50.00%, p=0.040).17of the21patients received antiviral therapy,12of them response, the other5didn’t. Compare to the antiviral therapy ineffective group, efficient group had lower disease activity scores (SAI:205.00±44.00vs239.50±24.50, p=0.024; CDAI:175.00±41.00vs272.00, P=0.001),more patients’ albumin level were higher than2.57g/dL (90.00%vs20.00%, p=0.047), shorter length of stay (22.00±18.00vs41.00±18.50d, p=0.014), and less UC patients accepted colectomy (0.00%vs60.00%, p=0.045). ConclusionThe high disease activity score was relative to Cytomegalovirus infection and the inefficacy of antiviral therapy.Early antiviral therapy was quite necessary for recurrent Inflammatory Bowel Disease patients with Cytomegalovirus infection. Patients with SAI score less than232, albumin level higher than2.57g/dL may have good response to antiviral therapy.