Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis
Background/AimsPatients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with U...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Association for the Study of Intestinal Diseases
2015-01-01
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| Series: | Intestinal Research |
| Subjects: | |
| Online Access: | http://www.irjournal.org/upload/pdf/ir-13-50.pdf |
| _version_ | 1818891936741720064 |
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| author | Jaeyoung Chun Changhyun Lee Ji-eun Kwon Sung Wook Hwang Sang Gyun Kim Joo Sung Kim Hyun Chae Jung Jong Pil Im |
| author_facet | Jaeyoung Chun Changhyun Lee Ji-eun Kwon Sung Wook Hwang Sang Gyun Kim Joo Sung Kim Hyun Chae Jung Jong Pil Im |
| author_sort | Jaeyoung Chun |
| collection | DOAJ |
| description | Background/AimsPatients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC.MethodsWe retrospectively reviewed the medical records of patients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as ≥1 pp65-positive cell per 2×105 polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive immunohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration.ResultsA total of 43 patients were enrolled. CMV antigenemia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P =0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P =0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P =0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P =0.025).ConclusionsThe CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia. |
| first_indexed | 2024-12-19T17:48:44Z |
| format | Article |
| id | doaj.art-2ce94d9678474a729c744560233827a9 |
| institution | Directory Open Access Journal |
| issn | 1598-9100 2288-1956 |
| language | English |
| last_indexed | 2024-12-19T17:48:44Z |
| publishDate | 2015-01-01 |
| publisher | Korean Association for the Study of Intestinal Diseases |
| record_format | Article |
| series | Intestinal Research |
| spelling | doaj.art-2ce94d9678474a729c744560233827a92022-12-21T20:11:58ZengKorean Association for the Study of Intestinal DiseasesIntestinal Research1598-91002288-19562015-01-01131505910.5217/ir.2015.13.1.50123Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative ColitisJaeyoung Chun0Changhyun Lee1Ji-eun Kwon2Sung Wook Hwang3Sang Gyun Kim4Joo Sung Kim5Hyun Chae Jung6Jong Pil Im7Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.Background/AimsPatients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC.MethodsWe retrospectively reviewed the medical records of patients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as ≥1 pp65-positive cell per 2×105 polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive immunohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration.ResultsA total of 43 patients were enrolled. CMV antigenemia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P =0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P =0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P =0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P =0.025).ConclusionsThe CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia.http://www.irjournal.org/upload/pdf/ir-13-50.pdfColitis, UlcerativeCytomegalovirusAntigensSteroidsTreatment failure |
| spellingShingle | Jaeyoung Chun Changhyun Lee Ji-eun Kwon Sung Wook Hwang Sang Gyun Kim Joo Sung Kim Hyun Chae Jung Jong Pil Im Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis Intestinal Research Colitis, Ulcerative Cytomegalovirus Antigens Steroids Treatment failure |
| title | Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis |
| title_full | Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis |
| title_fullStr | Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis |
| title_full_unstemmed | Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis |
| title_short | Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis |
| title_sort | usefulness of the cytomegalovirus antigenemia assay in patients with ulcerative colitis |
| topic | Colitis, Ulcerative Cytomegalovirus Antigens Steroids Treatment failure |
| url | http://www.irjournal.org/upload/pdf/ir-13-50.pdf |
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