Cytomegalovirus and Inflammatory Bowel Disease: pathogenicity, diagnosis and treatment

Abstract

Cytomegalovirus (CMV) infection is a common viral infection
in humans. In immunocompromised patients such as
transplant recipients and AIDS patients, CMV can cause severe
disease, affecting multiple organs including the gastrointestinal
tract. The role of CMV in patients with Inflammatory
Bowel Disease (IBD) is controversial. CMV has been associated
with onset of IBD, exacerbation of underlying IBD and
refractoriness to medical treatment in some studies, but has
been viewed as an "innocent bystander" in others. CMV infection
must be distinguished from CMV disease but this may
be difficult even with the newest diagnostic tests. Treatment
with ganciclovir or foscarnet with or without discontinuation
of immunosuppression, improves the clinical course of some
IBD patients with CMV disease. Thorough clinical and laboratory
evaluation is needed to identify those who will benefit
from antiviral treatment until further studies reveal the
exact role of CMV in the natural course of IBD.
Key Words: Cytomegalovirus, Inflammatory Bowel Disease,
ulcerative colitis, Crohn's disease, CMV colitis