Author:
Yang Hong,Wu Kaichun,Zhang Hongjie,Owyang Qin,Miao Yinglei,Gu Fang,Hu Naizhong,Zou Kaifang,Sheng Jianqiu,Li Jin,Zheng Ping,Liu Yulan,Li Junxia,Wang Xiaodi,Wu Yongdong,Yuan Yaozong,Chen Chunxiao,Pang Yanhua,Cui Meihua,Qian Jiaming
Abstract
Abstract
Background
Cytomegalovirus (CMV) infection can significantly complicate and worsen the condition of acute severe ulcerative colitis (UC) patients. We aimed to explore the predictive risk factors to prevent and identify CMV infection at an early stage in acute UC patients.
Methods
A total of 115 moderate-to-severe active UC patients from 17 hospitals throughout China were enrolled. Active CMV infection was diagnosed by one of the following: CMV pp65 antigens, CMV IgM antibodies or CMV DNA. We identified the independent risk factors by multivariate analyses.
Results
A total of 64 of 115 active UC patients had active CMV infection. Compared to the non-CMV-infected patients, the CMV-infected patients had a tendency to be male and to exhibit abdominal pain; fever; oral ulcers; eosinopenia; low albumin, immunoglobulin (Ig) A, IgM, and IgG levels; increased high-sensitivity C-reactive protein (hsCRP) levels; hyponatremia; pancolonic lesions; initial onset type; severe activity; and glucocorticoid (high-dose) and immunosuppressive agent use (P < 0.05). In further multivariate analyses, the use of high-dose glucocorticoids (OR 13.55, 95% CI 2.49–73.61, P < 0.01) and immunosuppressive agents (OR 11.23, 95% CI 1.05–119.99, P = 0.04) were independent risk factors for CMV infection. A decrease eosinophil and albumin levels were risk factors for CMV infection. With every 0.1*10^9/L decrease in the peripheral blood eosinophil level or 1 g/L decrease in the serum albumin level, the risk for CMV infection in UC patients increased by 5.21-fold (1/0.192) or 1.19-fold (1/0.839), respectively.
Conclusions
High-dose glucocorticoid and immunosuppressive agent treatment significantly increase the risk of CMV infection, and correcting eosinopenia and low albumin levels may help prevent CMV infection in UC patients.
Funder
Health Research & Special Projects Grant of China
The National Natural Science Fund
Ministry of Science and Technology of the People's Republic of China
Publisher
Springer Science and Business Media LLC
Subject
Gastroenterology,General Medicine
Cited by
8 articles.
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