Infection by cytomegalovirus in patients with ulcerative colitis requiring colonic resection

BACKGROUND: The objective was to determine the rate of colonic infection by cytomegalovirus (CMV) in patients with ulcerative colitis (UC) who have required colonic resection because of lack of response to medical treatment or complications. PATIENTS AND METHODS: Thirty nine patients (26 males, 13 females) colectomized because of refractory or complicated UC were included, Clinical and pharmacological characteristics were analyzed. Specific immunohistochemistry for CMV was performed in biopsic samples of ail specimens. RESULTS: Immunohistochemistry was positive for CMV in 7 out of the 39 patients. Since 1985 to 1994 there was only one case of CMV that contrasts with the 6 cases diagnosed from 1995 to 1998 (p < 0.05). All patients with CMV infection have received systemic corticosteroids before surgery, and additionally cyclosporine in 5 of them. Twenty two out of the 32 patients without CMV infection have also received corticosteroids, cyclosporine, azatioprine or methotrexate before surgery. The rate of immunosuppression was not different between the patients with or without CMV infection. Length of treatment before surgery was also similar for both groups of patients: (17 months (18-89) in non-infected group and 30 months (13-49) in CMV infected group; p = NS), Four patients infected by CMV died in the postoperatory. CONCLUSIONS:CMV infection in patients with refractory or complicated UC is a serious complication due to its frequency and prognosis. A significant increase in the prevalence of CMV infection, not related with differences in therapeutic immunosupression, has been observed in recent years.